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Schippers MC, Ioannidis JPA, Joffe AR. Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward. Front Public Health 2022; 10:950965. [PMID: 36159300 PMCID: PMC9491114 DOI: 10.3389/fpubh.2022.950965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
A series of aggressive restrictive measures were adopted around the world in 2020-2022 to attempt to prevent SARS-CoV-2 from spreading. However, it has become increasingly clear the most aggressive (lockdown) response strategies may involve negative side-effects such as a steep increase in poverty, hunger, and inequalities. Several economic, educational, and health repercussions have fallen disproportionately on children, students, young workers, and especially on groups with pre-existing inequalities such as low-income families, ethnic minorities, and women. This has led to a vicious cycle of rising inequalities and health issues. For example, educational and financial security decreased along with rising unemployment and loss of life purpose. Domestic violence surged due to dysfunctional families being forced to spend more time with each other. In the current narrative and scoping review, we describe macro-dynamics that are taking place because of aggressive public health policies and psychological tactics to influence public behavior, such as mass formation and crowd behavior. Coupled with the effect of inequalities, we describe how these factors can interact toward aggravating ripple effects. In light of evidence regarding the health, economic and social costs, that likely far outweigh potential benefits, the authors suggest that, first, where applicable, aggressive lockdown policies should be reversed and their re-adoption in the future should be avoided. If measures are needed, these should be non-disruptive. Second, it is important to assess dispassionately the damage done by aggressive measures and offer ways to alleviate the burden and long-term effects. Third, the structures in place that have led to counterproductive policies should be assessed and ways should be sought to optimize decision-making, such as counteracting groupthink and increasing the level of reflexivity. Finally, a package of scalable positive psychology interventions is suggested to counteract the damage done and improve humanity's prospects.
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Affiliation(s)
- Michaéla C. Schippers
- Department of Technology and Operations Management, Rotterdam School of Management, Erasmus University Rotterdam, Rotterdam, Netherlands,*Correspondence: Michaéla C. Schippers
| | - John P. A. Ioannidis
- Department of Medicine, Stanford University, Stanford, CA, United States,Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States,Department of Biomedical Data Science, Stanford University, Stanford, CA, United States,Department of Statistics, Stanford University, Stanford, CA, United States,Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, United States
| | - Ari R. Joffe
- Division of Critical Care Medicine, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada,John Dossetor Health Ethics Center, University of Alberta, Edmonton, AB, Canada
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Wang J, Zhao G, Song G, Liu J. Association between neuraxial labor analgesia and postpartum depression: A meta-analysis. J Affect Disord 2022; 311:95-102. [PMID: 35594971 DOI: 10.1016/j.jad.2022.05.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND Labor and delivery complications, particularly pain, are important risk factors for postpartum depression (PPD). Neuraxial labor analgesia can effectively relieve labor pain; however, the association between neuraxial labor analgesia and PPD, if any, has not been established. METHODS PubMed, MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library were searched. The incidence of PPD was the primary outcome. The secondary outcome was the difference in postpartum Edinburgh Postpartum Depression Scale scores between the neuraxial labor analgesia and control groups. Subgroup analyses and post-hoc meta-regression were performed. RESULTS Nineteen studies with a total of 8758 parturients were identified. Neuraxial labor analgesia did not decrease PPD risk compared to the control group (OR = 0.84, 95% CI: 0.58-1.23); however, after being stratified by PPD prevalence, neuraxial labor analgesia decreased the risk for PPD in the high prevalence (>14%) subgroup (OR = 0.61, 95% CI: 0.39-0.94) and increased the risk for PPD in the low prevalence (<14%) subgroup (OR = 1.56, 95% CI: 1.16-2.10) compared to the control group. Meta-regression analysis showed that the association between neuraxial labor analgesia and PPD was influenced by PPD prevalence. There was no difference in the postpartum Edinburgh Postpartum Depression Scale scores between the neuraxial labor analgesia and control groups (WMD = -0.11, 95% CI: -0.56-0.34). LIMITATION Heterogeneity and a limited number of randomized controlled trials may bias the interpretation of the results. CONCLUSION Neuraxial labor analgesia had a protective effect when administered to parturients in the region with a high prevalence of PPD, but became a risk factor when administered to parturients in the region with a low prevalence of PPD.
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Affiliation(s)
- Jian Wang
- Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ge Zhao
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China.
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Lee HJ, Lee DH, Jeon HJ, Lee DH, Yook V, Jeon JY. Development and Validation of the Self-Rating Suicide Risk Screening Questionnaire. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221119029. [PMID: 35968773 DOI: 10.1177/00302228221119029] [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: 12/22/2023]
Abstract
Since suicide is one of the major health problems worldwide, the goal of the present study is to develop a psychometrically sound suicide risk screening tool named Suicide Screening Questionnaire- Self-Rating (SSQ-SR) to quantify the risk of suicidal behavior. The development process includes item generation, item revision and refinement, and validation. A total sample of 2,238 adults in South Korea was used for analysis. The results of factor analysis showed that the SSQ-SR, containing 25 items, supported a three-factor model: "Situational factors," "Negative self-perceptions and mental health factors," and "Suicidal thoughts and behaviors." Also, SSQ-SR showed satisfying internal consistency, concurrent validity and discriminant validity. Lastly, the results of ROC analysis showed a cut-off point of 33.5 for the low-risk group and 36.5 for the high-risk group. Considering these results, the current results demonstrate the SSQ-SR is a valid scale and therefore can contribute to future suicide-related studies and prevention.
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Affiliation(s)
- Hwa Jung Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Dong Hun Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Vidal Yook
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Yeol Jeon
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
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Vilar A, Sánchez-Martínez N, Blasco MJ, Álvarez-Salazar S, Batlle Vila S, G Forero C. Content agreement of depressive symptomatology in children and adolescents: a review of eighteen self-report questionnaires. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02056-w. [PMID: 35962831 DOI: 10.1007/s00787-022-02056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/25/2022] [Indexed: 11/03/2022]
Abstract
Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management.
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Affiliation(s)
- Ana Vilar
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Institut de Neuropsiquiatria I Addiccions (INAD), Hospital de Dia Infanto Juvenil Litoral Mar, Parc de Salut Mar, Barcelona, Spain
| | - Néstor Sánchez-Martínez
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain
| | - Maria Jesús Blasco
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Health Services Research Group, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Samantha Álvarez-Salazar
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain
| | - Santiago Batlle Vila
- Institut de Neuropsiquiatria I Addiccions (INAD), Direcció Procés Atenció Comunitària I Programes Especials. Parc de Salut Mar, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carlos G Forero
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain.
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Shan JC, Chen IM, Lin PH, Chen WJ, Liao SC, Lee MB, Kuo PH. Associations between lifetime mental disorders and suicidal behaviors: findings from the Taiwan psychiatry morbidity survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1579-1589. [PMID: 35150308 DOI: 10.1007/s00127-022-02236-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/22/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND East Asia has high suicide rates but low prevalence of mental disorders. We examined the associations between prior lifetime mental disorders (mood disorders, anxiety disorders, substance use disorders, and impulse control disorders) and subsequent suicidal behaviors (suicidal ideation and attempts in the general population and suicide plans, planned attempts, and unplanned attempts in suicidal ideators) in Taiwan. METHODS This survey applied the World Mental Health Survey Composite International Diagnostic Interview to a population representative sample of noninstitutionalized adults between 2003 and 2005. Odds ratios (ORs) obtained using discrete-time survival analysis were used to estimate population attributable fractions (PAFs) of suicidal behaviors due to lifetime mental disorders. RESULTS Lifetime mental illness was a significant risk factor for subsequent suicidal behaviors (except unplanned attempts among ideators) despite the relatively low prevalence of mental disorders in people with suicidality (16.1%-35.0%). Each diagnosis increased the odds of suicidal ideation. In terms of acting on suicidal ideation, mood disorders were most strongly associated with having plans (OR = 10.0; 95% confidence interval, CI 4.3-21.1), whereas substance use disorders most strongly with either planned (OR = 27.3; 95% CI 6.3-118.5) or unplanned attempts (OR = 14.5; 95% CI 1.7-121.5). PAFs of all mental disorders on suicidality lay between 20 and 30% (except 11% of unplanned attempts among ideators). Mood, anxiety, and substance use disorders had higher PAFs than impulse control disorders. CONCLUSIONS In addition to mood disorders, considering anxiety and substance use disorders is essential in devising population-based suicide prevention strategies.
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Affiliation(s)
- Jia-Chi Shan
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
| | - Po-Hsien Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Wei J Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| | - Ming-Been Lee
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
- Department of Psychiatry, Shin Kong Wu Ho Su Hospital, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan
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Risk-Taking Behavior among Suicide Attempters. J Clin Med 2022; 11:jcm11144177. [PMID: 35887941 PMCID: PMC9320022 DOI: 10.3390/jcm11144177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 01/10/2023] Open
Abstract
Background: Suicidal behavior is a major mental health concern both for the individual and for the public health. Among others, suicidal behavior is associated with impulsivity, risk taking, pain tolerance, and a state of overarousal. In the present study, we investigated if suicide attempters (SAs) reported higher scores for risk-taking when compared with healthy controls (HC) of the general population. Methods: A total of 616 individuals (mean age: 27.07 years; 51.5% females) took part in the study; of those, 240 (39%) were individuals with a suicide attempt (SA) within a time lapse of one to three months, and 376 (61%) were healthy controls (HC). Participants completed a series of self-rating questionnaires covering sociodemographic information, risk-taking (Risk-Taking Questionnaire 18; RT-18), and suicidal behavior (Suicide Behaviors Questionnaire-Revised; SBQ-R). Results: Compared with HCs, individuals with SA reported higher risk-taking and suicidal behavior scores. The risk-taking questionnaire yielded a four-factor solution: Thrill and sensation seeking; Cautious procedure; Cautious decision making; Impulsive behavior. Compared with HCs, SAs showed the highest scores for thrill and sensation seeking and impulsive behavior. Conclusions: Compared with healthy controls, individuals reporting a recent suicide attempt also reported a higher propensity to thrill and sensation seeking and impulsive behavior as a proxy of risk-taking behavior. The present results corroborate the notion that, among others, suicide attempts appeared to be less related to premeditation, but rather to impulsive and thus spontaneous behavior.
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107
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Phoa PKA, Razak AA, Kuay HS, Ghazali AK, Rahman AA, Husain M, Bakar RS, Gani FA. The Malay Literacy of Suicide Scale: A Rasch Model Validation and Its Correlation with Mental Health Literacy among Malaysian Parents, Caregivers and Teachers. Healthcare (Basel) 2022; 10:healthcare10071304. [PMID: 35885830 PMCID: PMC9317984 DOI: 10.3390/healthcare10071304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
The 27-item Literacy of Suicide Scale (LOSS) is a test designed to measure the respondent’s suicide knowledge. The purpose of this study is to examine the psychometric properties of the Malay-translated version of the LOSS (M-LOSS) and its association to sociodemographic factors and mental health literacy. The 27-item LOSS was forward–backward translated into Malay, and the content and face validities were assessed. The version was distributed to 750 respondents across West Malaysia. Rasch model analysis was then conducted to assess the scale’s psychometric properties. The validated M-LOSS and the Malay version of the Mental Health Knowledge Schedule (MAKS-M) were then distributed to 867 respondents to evaluate their level of suicide literacy, mental health literacy, and their correlation. Upon Rasch analysis, 26 items were retained. The scale was found to be unidimensional, with generally satisfying separation and reliability indexes. Sex, socio-economic status, and experience in mental health were found to significantly impact the mean score for mental health literacy. This study also found a significant mean difference for suicide literacy across school types. Furthermore, while this study observed a weak but significant negative correlation between age and suicide literacy, no correlation was found between mental health and suicide literacy.
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Affiliation(s)
- Picholas Kian Ann Phoa
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (P.K.A.P.); (H.S.K.); (M.H.); (R.S.B.)
| | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (P.K.A.P.); (H.S.K.); (M.H.); (R.S.B.)
- Correspondence:
| | - Hue San Kuay
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (P.K.A.P.); (H.S.K.); (M.H.); (R.S.B.)
| | - Anis Kausar Ghazali
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Maruzairi Husain
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (P.K.A.P.); (H.S.K.); (M.H.); (R.S.B.)
| | - Raishan Shafini Bakar
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (P.K.A.P.); (H.S.K.); (M.H.); (R.S.B.)
| | - Firdaus Abdul Gani
- Department of Psychiatry and Mental Health, Sultan Haji Ahmad Shah Hospital, Temerloh 25000, Pahang, Malaysia;
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Crișan RM, Băcilă CI, Morar S. The role of psychological autopsy in investigating a case of atypical suicide in schizophrenia: a case report with a brief review of literature. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022; 12:30. [PMID: 35815293 PMCID: PMC9257119 DOI: 10.1186/s41935-022-00291-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/26/2022] [Indexed: 02/08/2023] Open
Abstract
Background Self-harm typically is without lethal intent. Death can occur rarely, with suicide taking on an atypical form that raises the suspicion of hetero-aggression. Our study aimed to identify the link between self-harm and suicide intent and also to outline the positive diagnosis of an atypical suicide case which has raised the suspicion of hetero-aggression. For this purpose, the psychological autopsy method should be used regularly in suicide investigation because it not only allows a positive diagnosis of suicide but can also provide a detailed picture of mental degradation and associated suicide risk factors. Case presentation The case of a 26-year-old man from a rural area, found dead in the basement, at home, naked, barricaded inside, is described. Methods The on-site investigation and a complete forensic autopsy were performed. In addition, we apply the psychological autopsy method which gathered enough information to outline the positive diagnosis of suicide. We also made a brief literature review on the suicide risk factors and the behavioral changes that occurred during the COVID-19 pandemic in schizophrenic patients. Results The forensic autopsy revealed that he presented a complex craniofacial trauma as the cause of death (with scalp lacerations, frontal fracture, subarachnoid hemorrhage, and frontal cerebral contusions) associated with torso trauma (with self-inflicted stabbed wounds) with bruises and abrasions on the limbs. The injuries that caused death were self-inflicted and ensued repeatedly hitting his head against blunt objects. Using the psychological autopsy method, we found out that he presented multiple psychiatric hospitalizations for schizophrenia for almost 10 years, recently with reduced compliance to treatment. We also documented two previous suicide attempts and a gradual deterioration of his mental health. Conclusions We highlighted the role of the psychological autopsy (in addition to the judicial investigation and the forensic autopsy) for the diagnosis of committed suicide, for making a rigorous differential diagnosis between accident, hetero-aggression, and suicide, and also in pin-pointing the suicide risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s41935-022-00291-5.
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Mobley K, Taasoobshirazi G. Predicting Suicide in Counties: Creating a Quantitative Measure of Suicide Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138173. [PMID: 35805832 PMCID: PMC9266634 DOI: 10.3390/ijerph19138173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/17/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
Rising rates of suicide over the past two decades have increased the need for wide-ranging suicide prevention efforts. One approach is to target high-risk groups, which requires the identification of the characteristics of these population sub-groups. This suicidology study was conducted using large-scale, secondary data to answer the question: using the research on suicide, are there variables studied at the community level that are linked to suicide and are measurable using quantitative, demographic data that are already collected and updated? Data on deaths from suicide in U.S. counties for the years 2000, 2005, 2010 and 2015 were analyzed using multiple regression, longitudinal regression, and cluster analysis. Results indicated that the suicide rate in a county can be predicted by measuring the financial stability of the residents, the quality of mental health in the county, and the economic opportunity in the county. The results are further analyzed using two sociological theories, Social Strain Theory and the Theory of Anomie, and two psychological theories, the Shame Model and the Interpersonal Theory of Suicide.
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Schwartz-Lifshitz M, Ben-Dor DH, Bustan Y, Zalsman G, Gothelf D, Weizman A, Barzilay R. Phenotypic Characterization of Youth Admitted To Acute Psychiatric Inpatient Unit Following Self-Harm Behavior. Arch Suicide Res 2022; 26:1186-1197. [PMID: 33403931 PMCID: PMC9534345 DOI: 10.1080/13811118.2020.1865223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit. METHOD We retrospectively analyzed data from the electronic medical records of consecutive admittances to a single acute adolescent inpatient unit (n = 703, mean age 15.2). We compared inpatients with DSH to inpatients without DSH and further compared within the DSH group based on the presence of suicidal intent. RESULTS Compared to Non-DSH inpatients (n = 497), youths admitted following DSH (n = 206) were more likely to be female (OR = 2.6, 95%CI 1.7-4), currently in depressive exacerbation (OR = 2.4, 95%CI 1.6-3.6), with concurrent suicidal ideation (OR = 3.9, 95%CI 2.5-5.9), and history of alcohol use (OR = 5.6, 95%CI 3.2-9.5). Within DSH youths, no significant clinical differences were identified between those admitted following a suicide attempt (n = 102) compared to non-suicidal-self-injury (n = 104), who were generally younger. CONCLUSIONS Findings suggest that early detection and intervention of DSH and depressive crisis is warranted, regardless of the self-harm subtype.HIGHLIGHTSDeliberate self-harm is common among adolescent psychiatric inpatients.Adolescent inpatients with deliberate self-harm are predominantly females with concurrent depression and suicidal ideation.We did not detect significant clinical and demographic differences between self-harmers with or without suicidal intent.
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Ordóñez-Carrasco JL, Cuadrado Guirado I, Rojas Tejada A. Scale of psychological pain: Spanish adaptation of the Psychache Scale in young adults. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:196-204. [PMID: 36184539 DOI: 10.1016/j.rpsmen.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Psychological pain is understood as an intolerable and disturbing mental state characterized by an internal experience of negative emotions. This study was aimed at making a Spanish adaptation of the Psychache Scale by Holden and colleagues in a sample of young adults. MATERIAL AND METHODS The scale evaluates psychological pain as a subjective experience. It is composed of 13 items with a Likert-type response format. Following the guidelines of the International Tests Commission for the adaptation of the test, we obtained a version conceptually and linguistically equivalent to the original scale. Through an online questionnaire, participants completed the psychological pain scale along with other scales to measure depression (BDI-II), hopelessness (Beck's scale of hopelessness) and suicide risk (Plutchik suicide risk scale). The participants were 234 people (94 men, 137 women and three people who identified as a different sex) from 18 to 35 years old. RESULTS The EFA showed a one-factor solution, and the FCA revealed adequate indexes of adjustment to the unifactorial model. It also showed good reliability of the test scores. The evidence of validity of the scale in relation to the other variables showed high, positive and statistically significant correlations with depression, hopelessness, suicidal ideation and suicidal risk. CONCLUSION In summary, this Spanish adaptation of the Psychache Scale could contribute to improving the evaluation of both the patient with suicide risk and the effectiveness of psychological therapy, as well as suicidal behaviour prevention and intervention.
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Sanches M, Nguyen LK, Chung TH, Nestadt P, Wilcox HC, Coryell WH, Soares JC, Selvaraj S. Anxiety symptoms and suicidal thoughts and behaviors among patients with mood disorders. J Affect Disord 2022; 307:171-177. [PMID: 35331824 PMCID: PMC9321173 DOI: 10.1016/j.jad.2022.03.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across different mood disorders is still unclear. METHODS We performed a registry-based retrospective study utilizing outcome measure data collected by the National Network of Depression Centers (NNDC), a nationwide nonprofit consortium of 26 leading clinical and academic member centers in the United States. The sample consisted of 2607 outpatients with mood disorders (major depressive disorder or bipolar disorders). Demographic and clinical variables were compared based on the presence or absence of STB and severity of anxiety symptoms (minimal, mild, moderate, and severe). Univariate and multivariable logistic regressions were conducted to examine the correlations of STB, considering multicollinearity. RESULTS Patients with mild, moderate, and severe anxiety symptoms had higher odds of STB than those with minimal symptoms. Gender, marital status, age, and depressive symptoms were other strong predictors of STB. There was no difference in the odds of STB between patients with major depressive disorder (MDD) and those with bipolar disorders (BD). However, the odds of suicidal ideation were slightly lower among patients with BD than those with MDD. LIMITATIONS Our sample was comprised only of outpatients, limiting the generalization of our findings. Other limitations include the lack of structured interviews for diagnostic characterization of the patients and the utilization of data on anxiety and mood obtained solely through self-report scales. CONCLUSIONS We found a cross-sectional association between the severity of anxiety symptoms and STB among patients with mood disorders. This study demonstrates the need for a suicide risk assessment in patients with mood disorders reporting anxiety symptoms.
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Affiliation(s)
- Marsal Sanches
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA.
| | - Linh K Nguyen
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tong Han Chung
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William H Coryell
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Jair C Soares
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA
| | - Sudhakar Selvaraj
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA
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Ranapurwala SI, Miller VE, Carey TS, Gaynes BN, Keil AP, Fitch CV, Swilley-Martinez ME, Kavee AL, Cooper T, Dorris S, Goldston DB, Peiper LJ, Pence BW. Innovations in suicide prevention research (INSPIRE): a protocol for a population-based case-control study. Inj Prev 2022; 28:injuryprev-2022-044609. [PMID: 35701110 PMCID: PMC10213808 DOI: 10.1136/injuryprev-2022-044609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Suicide deaths have been increasing for the past 20 years in the USA resulting in 45 979 deaths in 2020, a 29% increase since 1999. Lack of data linkage between entities with potential to implement large suicide prevention initiatives (health insurers, health institutions and corrections) is a barrier to developing an integrated framework for suicide prevention. OBJECTIVES Data linkage between death records and several large administrative datasets to (1) estimate associations between risk factors and suicide outcomes, (2) develop predictive algorithms and (3) establish long-term data linkage workflow to ensure ongoing suicide surveillance. METHODS We will combine six data sources from North Carolina, the 10th most populous state in the USA, from 2006 onward, including death certificate records, violent deaths reporting system, large private health insurance claims data, Medicaid claims data, University of North Carolina electronic health records and data on justice involved individuals released from incarceration. We will determine the incidence of death from suicide, suicide attempts and ideation in the four subpopulations to establish benchmarks. We will use a nested case-control design with incidence density-matched population-based controls to (1) identify short-term and long-term risk factors associated with suicide attempts and mortality and (2) develop machine learning-based predictive algorithms to identify individuals at risk of suicide deaths. DISCUSSION We will address gaps from prior studies by establishing an in-depth linked suicide surveillance system integrating multiple large, comprehensive databases that permit establishment of benchmarks, identification of predictors, evaluation of prevention efforts and establishment of long-term surveillance workflow protocols.
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Affiliation(s)
- Shabbar I Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vanessa E Miller
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Timothy S Carey
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Vinita Fitch
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Monica E Swilley-Martinez
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Andrew L Kavee
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Toska Cooper
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Samantha Dorris
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lewis J Peiper
- Division of Adult Correction - Prisons, North Carolina Department of Public Safety, Raleigh, North Carolina, USA
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
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da Fonsêca JR, de Oliveira CM, de Castro CCL, da Costa HVV, Galvão PVM, da Costa Ceballos AG, do Bonfim CV. Analysis of the completeness of self-harm and suicide records in Pernambuco, Brazil, 2014-2016. BMC Public Health 2022; 22:1154. [PMID: 35681172 PMCID: PMC9178859 DOI: 10.1186/s12889-022-13455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Suicides and suicide attempts are major public health problems, and coping strategies are hampered by insufficient or inadequate notifications. Data accuracy influences the formulation of public and mental health policies and suicide prevention strategies. The objective of this study was to analyze the completeness of self-harm and suicide records in the state of Pernambuco, Brazil, 2014-2016. METHODS This is an evaluative study with a descriptive design. The data were collected from suicide attempt records from the Notifiable Diseases Information System and suicide records from the Mortality Information System. Probabilistic linkage was used to relate these databases, and the degree of completeness of the variables was calculated. Completeness was classified into the following categories: good (≥ 75.1%), regular (50.1%-75.0%), low (25.1%-50.0%), and very low (≤ 25.0%). RESULTS In the analyzed period, 1,404 notifications of self-harm were studied, with an overall mean completeness of 86.2%. In addition, 1,050 suicide records were analyzed, with an overall mean completeness of 95.8%. Most variables referring to suicide attempts had good completeness, with the exception of the variables "occupation" and "education." The completeness of all suicide-related variables was rated as good. After linkage, a significant improvement was observed in the degree of completeness of the variable "occupation". CONCLUSION The results of this study showed that the completeness of self-harm and suicide variables improved from the first to the last year. The integration of data from different information systems provides an opportunity to improve suicide prevention programs and the quality of available information. Continuous efforts to increase the completeness and reliability of suicide surveillance systems are fundamental to describe the epidemiological profile and, consequently, plan preventive actions, in addition to contributing to the development and reformulation of strategies aimed at reducing morbidity and mortality related to suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | - Cristine Vieira do Bonfim
- Directorate of Social Research, Joaquim Nabuco Foundation, Rua Dois Irmãos, 92 - Ed. Anexo Anísio Teixeira - Apipucos, Recife, PE, CEP 52071-440, Brazil.
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Costanza A, Vasileios C, Ambrosetti J, Shah S, Amerio A, Aguglia A, Serafini G, Piguet V, Luthy C, Cedraschi C, Bondolfi G, Berardelli I. Demoralization in suicide: A systematic review. J Psychosom Res 2022; 157:110788. [PMID: 35334350 DOI: 10.1016/j.jpsychores.2022.110788] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation (SI)/suicidal behavior (SB) and demoralization in populations of community-dwellers and patients with somatic or psychiatric disorders. METHODS We employed a systematic approach that followed PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, Science Direct, and PsychINFO) for relevant titles/abstracts published from January 1980-June 2021. We included original studies that explicitly mentioned the investigation of a potential association between SI/SB and demoralization. RESULTS A total of 18 studies met our inclusion criteria. Their synthesis revealed that demoralization can be associated with SI/SB in a wide range of populations (community dwellers, patients with somatic or psychiatric disorders) and lead to significantly higher suicide risk (odds ratios of >6 were encountered in community dwellers experiencing financial hardship or isolation). Moreover, demoralization alone (about half the patients who were demoralized did not meet the criteria for an affective disorder nor were they clinically depressed) or together with depression has been identified as a major risk factor for SI/SB. Regarding the crucial issue of progression from SI to SA, in the context of the "ideation-to-action" frame, some authors found that the interaction of demoralization and over-arousal could be a useful predictor for this progression, while others found that depression alone was sufficient to differentiate attempters from non-attempters or the interaction with shutdown (helplessness and low positive emotions). CONCLUSION These results emphasize the possibility to identify demoralization as an independent risk factor for suicide. In patients with psychiatric disorders, the association between demoralization and SI/SB may be transnosographic. Overall, from the clinical implications perspective, our findings highlight that: i. Assessment of demoralization may contribute to a more comprehensive suicide risk detection. This appears particularly relevant in Emergency Departments (EDs) where heterogeneous population typologies are usually admitted and a clinical diagnosis of depression is often difficult to be defined. ii. Additionally, since meaninglessness is considered one of the demoralization subcomponents, meaning-centered psychotherapeutic approaches prove to be indicated and they can be initiated already at the EDs upon first contact with the patient. Further studies are necessary to confirm these findings.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - Chytas Vasileios
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Julia Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland
| | - Sanam Shah
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm U1018, Paris, France
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Valérie Piguet
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre (MPC), University Hospitals of Geneva (HUG), Switzerland; Division of General Medical Rehabilitation, Geneva University Hospitals (HUG), Switzerland; Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Comparing characteristics of suicide to non-suicide drug poisoning deaths, by sex, in Ireland. J Affect Disord 2022; 306:80-89. [PMID: 35306124 DOI: 10.1016/j.jad.2022.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/17/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Suicide by drug poisoning is potentially preventable; however, evidence on associated risk factors by sex is limited. AIM To assist in understanding how individual and social contextual factors, and specific drugs, influence risk of suicide compared to non-suicide drug poisoning deaths, and how this differs by sex. METHODS Data were extracted from the National Drug-Related Deaths Index. Analysis included univariable and multivariable logistic regression to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) for factors associated with suicide drug poisoning deaths (SDPD) (primary outcome) compared with non-suicide drug poisoning deaths (NSDPD) and stratified by sex. RESULTS SDPD accounted for 240 (22%) of 1114 poisoning deaths, the majority among men (n = 147, 61%). Increasing age, mental ill health (AOR 7.85, 95% CI: 5.46-11.28), chronic pain (AOR 5.57, 95% CI: 3.28-9.46), and history of previous overdose (AOR 5.06, 95% CI: 3.39-7.56) were associated with increased odds of SDPD, with similar results for both sexes. The main drugs associated with SDPD were non-opioid analgesics (OR 4.06 [95% CI 2.66-6.18]), antipsychotics (OR 2.42 [95% CI 1.63-3.60]) and antidepressants (OR 2.18 [95% CI 1.59-2.97]). Pregabalin was associated with SDPD among women only. LIMITATIONS Secondary analysis of coronial data on drug poisoning deaths therefore findings may not be relevant to suicide deaths in general. CONCLUSIONS Ongoing monitoring for signs of suicidal intent in individuals with mental illness, chronic pain, overdose, and/or prescribed mental health medications may identify individuals in need of additional intervention.
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Lee JI, Kim E, Kim HJ, Lee DH. Factors influencing the successful connection of deliberate self-injury patients to community-based mental health centers. Asian J Psychiatr 2022; 72:103088. [PMID: 35358763 DOI: 10.1016/j.ajp.2022.103088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The emergency department (ED) is a good place to start preventing actions for suicide attempters. As a preventive factor, early intervention, follow-up management, and connection with community-based mental health care are important. We aimed to determine which factors were important for a successful connection to community-based mental health care services. METHODS This study was conducted at two tertiary teaching hospitals from January 2018 to December 2020. There were 1016 deliberate self-harm patients who received the four weeks of follow-up intervention. RESULTS There were 166 patients in the connected group and 850 patients in the non-connected group. In the logistic regression analysis for the successful connection to community-based mental health care, married patients had an odds ratio (OR) 1.627 (95% CI 0.960-2.758), 1.314 OR (95% CI 0.619-2.790) of separated patients and 5.317 OR (CI 1.864-15.168) of widowed patients compared to single patients. And face-to-face follow-up management had 2.630 OR (95% CI 1.815-3.811) to the successful connection rate to community-based mental healthcare compared to the patients in non-face-to-face management. CONCLUSION When deliberately self-injured patients who visited the ED received short-term follow-up intervention after emergency treatment, face-to-face follow-up intervention had a higher connection rate to community-based mental healthcare centers than non-face-to-face follow-up intervention. In the future, for deliberate self-harm patients who visit the ED, the ED staff should manage deliberate self-harm through early detection and face-to-face follow-up intervention, and other methods that can compensate for face-to-face follow-up intervention.
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Affiliation(s)
- Jung Il Lee
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, South Korea
| | - Eun Kim
- Department of Emergency Medicine, Ewha Womans University, Seoul, South Korea
| | - Hye Jin Kim
- Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
| | - Duk Hee Lee
- Department of Emergency Medicine, Ewha Womans University, Seoul, South Korea.
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Na PJ, Stefanovics EA, Rhee TG, Rosenheck RA. "Lives of despair" at risk for "deaths of despair": tracking an under-recognized, vulnerable population. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1123-1134. [PMID: 35028698 PMCID: PMC8757395 DOI: 10.1007/s00127-022-02218-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The substantial and unexpected increase in "deaths of despair" in the US (e.g., deaths from drug overdose, suicide, and alcohol-related liver diseases) reported by economists Case and Deaton in 2015 raises questions about the number and characteristics of US adults potentially living "lives of despair" with these problems. METHODS We used data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III (NESARC-III) to examine population estimates and characteristics of adults with lifetime history of substance use disorder (SUD) and suicide attempt, or either condition alone, as compared to those with neither. RESULTS An estimated 7.2 million adults had both lifetime SUD and suicide attempt and 78.8 million had either. Those with both faced far more psychosocial adversities, familial adverse experiences and psychiatric disorders compared to those with the other two groups, and reported greater mental health service utilization. Multivariable analysis showed that psychiatric multimorbidity and violence were the strongest correlates of having both conditions as compared to neither while those with either condition fell in between. CONCLUSION A substantial number of US adults live with a lifetime SUD and suicide attempt with a multiplicity of additional socioeconomic, psychiatric and familial problems. While their utilization of mental health care service exceeds those with either or neither conditions, quality of life remained much poorer, suggesting that mental health treatment alone may not be enough to mitigate their sufferings, and a combination of both social policy support and quality mental health care may be needed.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry, School of Medicine, Yale University, 300 George St, Suite 901, West Haven, New Haven, CT, 06511, USA.
| | - Elina A Stefanovics
- Department of Psychiatry, School of Medicine, Yale University, 300 George St, Suite 901, West Haven, New Haven, CT, 06511, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, New Haven, CT, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, School of Medicine, Yale University, 300 George St, Suite 901, West Haven, New Haven, CT, 06511, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, New Haven, CT, USA
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Robert A Rosenheck
- Department of Psychiatry, School of Medicine, Yale University, 300 George St, Suite 901, West Haven, New Haven, CT, 06511, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, New Haven, CT, USA
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Sakashita T, Oyama H. Suicide Prevention Interventions and Their Linkages in Multilayered Approaches for Older Adults: A Review and Comparison. Front Public Health 2022; 10:842193. [PMID: 35619820 PMCID: PMC9127334 DOI: 10.3389/fpubh.2022.842193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Multilayered approaches to suicide prevention combine universal, selective, and indicated prevention interventions. These approaches may be more successful in reducing suicide rates among older adults if they link these layers more systematically: that is, if the programs are designed so that interventions at a lower level facilitate involvement at a higher level when appropriate. This study aimed to examine the effect on suicide rates of the structure of multilayered approaches, and in particular the types of interventions and the connections or linkages between them. We also wished to consider any different effects by sex. A literature search used PubMed and PsycINFO to identify systematic reviews of interventions in this age group. From the reference lists of these articles, we identified controlled studies assessing the impact of a multilayered program on suicide incidence among older adults. We were particularly interested in initiatives linking different kinds of prevention interventions. We found three relevant systematic reviews, and from these, we identified nine eligible studies. These included seven non-randomized controlled studies from rural areas in Japan (average eligible population: 3,087, 59% women, average duration: 8 years). We also found two cohort studies. The first was from a semi-urban area in Padua, Italy (18,600 service users, 84% women, duration: 11 years). The second was from urban Hong Kong, with 351 participants (57% women) over a 2-year follow-up period. We used a narrative synthesis of these studies to identify five different multilayered programs with different forms of connections or linkages between layers. Two studies/programs (Italy and Hong Kong) involved selective and indicated prevention interventions. One study/program (Yuri, Japan) included universal and selective prevention interventions, and the final six studies (two programs in northern Japan) involved linkages between all three layers. We also found that these linkages could be either formal or informal. Formal linkages were professional referrals between levels. Informal linkages included advice from professionals and self-referrals. Several of the studies noted that during the program, the service users developed relationships with services or providers, which may have facilitated movements between levels. All five programs were associated with reduced suicide incidence among women in the target groups or communities. Two programs were also associated with a reduction among men. The study authors speculated that women were more likely to accept services than men, and that the care provided in some studies did less to address issues that are more likely to affect men, such as suicidal impulsivity. We therefore suggest that it is important to build relationships between levels, especially between selective and indicated prevention interventions, but that these can be both formal and informal. Additionally, to reach older men, it may be important to create systematic methods to involve mental health professionals in the indicated prevention intervention. Universal interventions, especially in conjunction with systematically linked indicated and selective interventions, can help to disseminate the benefits across the community.
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Affiliation(s)
- Tomoe Sakashita
- Department of Social Welfare, Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
| | - Hirofumi Oyama
- Department of Social Welfare, Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
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Risk and Protective Factors Associated with Suicidal Thoughts and Behaviors Among Maryland Middle School Students. SCHOOL MENTAL HEALTH 2022; 14:1024-1043. [PMID: 35669255 PMCID: PMC9145114 DOI: 10.1007/s12310-022-09521-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to identify independent risk and protective factors associated with self-reported suicidal thoughts and behaviors (STB) among young adolescents by examining self-report data on mental health, substance abuse, violence involvement, social and economic challenges and supports, physical health and demographics in relation to STB. Data from nearly 27,000 students who completed the 2018-19 Maryland Middle School Youth Risk Behavior Survey/Youth Tobacco Survey (YRBS/YTS) were used to identify independent risk and protective factors associated with STB among middle school students (grades 6–8; ages 11-14). Twenty-three percent of students reported lifetime suicidal ideation and nine percent reported lifetime attempt(s). Independent risk factors associated with STB include depression, substance abuse or misuse, violence involvement, bullying victimization at school or electronically, sexual activity, and sleep deprivation. Protective factors include having an adult outside of school to confide in and feeling that teachers care and provide encouragement. Interactive effects by gender and/or race/ethnicity were observed for some factors in relation to STB. These results suggest that evidence-based programs and policies at the universal and selective/indicated levels in school settings are needed and should be introduced earlier on to address the widespread prevalence of STB in young adolescents. Program planners should take into consideration social, cultural and language needs when implementing and developing intervention strategies.
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Jeong SH, Hoon Kim S, Lee DW, Park EC, Jang SY. Association between new-onset Parkinson's disease and suicide risk in South Korea: a nationwide cohort study. BMC Psychiatry 2022; 22:341. [PMID: 35581575 PMCID: PMC9115980 DOI: 10.1186/s12888-022-03990-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is an increasingly common neurodegenerative disease in an aging society. Whether PD is associated with an increased suicide risk is unclear. Thus, we investigated the effect of new-onset PD on suicide. METHODS Using the National Health Insurance Service Senior Sample Cohort of South Korea, 17,143 incident PD patients and 17,143 risk set controls, matched by propensity score, were selected for follow-up. The incidence rate of suicide and 95% confidence interval (CI) were calculated based on a generalized linear model of the Poisson distribution. Effect sizes were expressed as hazard ratios (HRs) using the Cox proportional hazards model with a robust variance estimator that incorporated clustering within matched pairs. RESULTS The incidence rate of suicide was 206.7 cases per 100,000 person-years (95% CI, 172.8-246.9) among the PD cohort. Compared to the matched controls, patients with PD were 2.64 times (HR, 2.64; 95% CI, 1.31-5.30) more likely to commit suicide during the first 180 days of follow-up and 2.47 times (HR, 2.47; 95% CI, 1.42-4.28) within the first 365 days of follow-up. During the entire follow-up period, patients with PD were 2.26 times more likely to commit suicide than were their matched controls (HR, 2.26; 95% CI, 1.67-3.06). CONCLUSION Our findings indicated an increased risk of suicide in patients with new-onset PD, regardless of the period after diagnosis. Incorporating mental health care with social and environmental interventions into primary care and PD-specialized care can help reduce suicide risk in people with PD, improving suicide prevention, identification, and risk assessment.
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Affiliation(s)
- Sung Hoon Jeong
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hoon Kim
- grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Doo Woong Lee
- grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Healthcare Management, Graduate School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Marco JH, Fonseca S, Fernandez-Felipe I, García-Palacios A, Baños R, Perez S, Garcia-Alandete J, Guillen V. Family connections vs treatment at usual optimized in the treatment of relatives of people with suicidal behavior disorder: study protocol of a randomized control trial. BMC Psychiatry 2022; 22:335. [PMID: 35570289 PMCID: PMC9107725 DOI: 10.1186/s12888-022-03965-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatives of people diagnosed with suicidal behavior disorder (SBD) feel guilty, afraid, hopeless, depression and anxiety. It is necessary to help the relatives of people with SBD to reduce their discomfort and burden. Family Connections (FC) is a program that has been shown to be effective in reducing burden, depression, and anxiety, and increasing dominance and validating behaviors in relatives of people with borderline personality disorder. However, there are no RCTs that demonstrate the efficacy of the FC program in patients with SBD. Our research team adapted FC for relatives of people with SBD for delivery in the Spanish population (FC-SBD). The FC-SBD program contains 12 two-hour sessions held once a week. The first aim is to verify the efficacy of the FC-SBD intervention for relatives of people diagnosed with SBD in a randomized control trial with a Spanish sample. The second objective is to analyze the feasibility and acceptance of FC-SBD in relatives. The third aim is to analyze whether the changes produced in the psychological variables in the relatives after the intervention are related to changes in the psychological variables of the patients. This paper presents the study protocol. METHODS The study design consists of a two-arm randomized controlled trial with two conditions: FC-SBD or Treatment as usual optimized (TAU-O). Participants will be relatives of patients who meet DSM-5 criteria for SBD. The caregivers` primary outcome measures will be the BAS. Secondary outcomes will be DASS-21, FES, DERS, QoL. The patient's primary outcome measures will be the frequency of critical incidents with the family member with SBD. Secondary measures will be the INQ, PHQ-9, OASIS. Participants will be assessed at pretreatment, post-treatment, and 6-month follow-up. The intention-to-treat principle will be used when analyzing the data. DISCUSSION This study will provide results that confirm the efficacy of the FC-SBD in relatives of people with SBD. These results will also confirm its good acceptance by family members and help us to find out whether it is a good program to improve the prevention of suicidal behaviors in the family environment. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05157607 . Registered 15 December 2021.
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Affiliation(s)
- José H. Marco
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España ,grid.484042.e0000 0004 5930 4615Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, España
| | - Sara Fonseca
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España
| | - Isabel Fernandez-Felipe
- grid.9612.c0000 0001 1957 9153Universitat Jaume I de Castelló, España. Facultad de Ciencias de la Salud, Avda Sos Baynat, S/N, Castellón, España
| | - Azucena García-Palacios
- grid.484042.e0000 0004 5930 4615Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, España ,grid.9612.c0000 0001 1957 9153Universitat Jaume I de Castelló, España. Facultad de Ciencias de la Salud, Avda Sos Baynat, S/N, Castellón, España
| | - Rosa Baños
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España ,grid.484042.e0000 0004 5930 4615Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, España
| | - Sandra Perez
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España
| | - Joaquín Garcia-Alandete
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España
| | - Verónica Guillen
- grid.5338.d0000 0001 2173 938XDepartamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Valencia, Facultad de Psicología, España. Avda. Blasco Ibañez, 21, Valencia, España ,grid.484042.e0000 0004 5930 4615Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, España
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Høier NK, Madsen T, Spira AP, Hawton K, Benros ME, Nordentoft M, Erlangsen A. Association between hospital-diagnosed sleep disorders and suicide: a nationwide cohort study. Sleep 2022; 45:zsac069. [PMID: 35554572 DOI: 10.1093/sleep/zsac069] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/22/2022] [Indexed: 01/10/2023] Open
Abstract
STUDY OBJECTIVES Sleep disorders are related to mental disorders. Yet few studies have examined their association with suicide. We examined whether males and females diagnosed with sleep disorders had higher rates of suicide than individuals not diagnosed with sleep disorders. METHODS In a cohort study, nationwide data on all males and females aged over 15 years living in Denmark during 1980-2016 were analyzed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence rate ratios (IRR) were estimated using Poisson regression models and adjusted for covariates. RESULTS In all, 3 674 563 males and 3 688 164 females were included, of whom 82 223 (2.2%, mean age: 50.2 years, SD: 17.5) males and 40 003 (1.1%, mean age: 50.6 years, SD: 19.9) females had sleep disorder diagnoses. Compared with those with no sleep disorders, the adjusted IRR for suicide were 1.6 (95% CI, 1.4 to 1.7) and 2.2 (95% CI, 1.8 to 2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR: 1.2, 95% CI, 1.0 to 1.5) and females (IRR: 3.3, 95% CI, 3.0 to 4.1), and for sleep apnea in males (IRR: 1.8, 95% CI, 1.5 to 2.2). A difference with respect to age and sex was observed (p < 0.001) between males and females. Males and females had IRR of 4.1 (95% CI, 3.1 to 5.5) and 7.0 (95% CI, 4.8 to 10.1), during the first 6 months after being diagnosed with a sleep disorder. CONCLUSIONS Sleep disorders were associated with higher suicide rates even after adjusting for preexisting mental disorders. Our findings suggest attention toward suicidality in patients with sleep disorders is warranted.
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Affiliation(s)
- Nikolaj Kjær Høier
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Trine Madsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, Faculty of Health, University of Copenhagen, Denmark
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Michael Eriksen Benros
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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124
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Helgesson M, Björkenstam E, Filatova S, Rahman SG, Cullen A, Dorner T, Gémes K, Amin R, Mittendorfer-Rutz E. Mental and somatic disorders and the subsequent risk of all-cause and cause-specific mortality in refugees, non-refugee migrants and the Swedish-born youth: a population-based cohort study in Sweden. BMJ Open 2022; 12:e054351. [PMID: 35545376 PMCID: PMC9096569 DOI: 10.1136/bmjopen-2021-054351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/24/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aims were to investigate the associations between specific mental and somatic disorders and subsequent all-cause and cause-specific mortality (suicide, external and other causes) in young refugees and non-refugee migrants compared with Swedish-born individuals of similar age. METHODS In this register-based prospective cohort study, all 1 003 760 individuals (40 305 refugees, 31 687 non-refugee migrants as the exposure groups and the rest as the Swedish-born comparison group), 16-25 years old, residing in Sweden on 31 December 2004 were included. These individuals were followed regarding the outcome of all-cause and cause-specific mortality (suicide and external causes) between 2005 and 2016. The study population was also stratified according to any use of specialised healthcare for mental or somatic diagnoses before baseline (2000-2004). Cox regression models yielding crude and multivariate Hazard Ratios (HR and aHR, respectively) with 95% Confidence Intervals (CI) were used to investigate the afore-mentioned associations. RESULTS A lower proportion of both refugees (12%) and non-refugee migrants (10%) had college/university education compared with the Swedish-born individuals (17%). The proportion of unemployed (>180 days) among refugees (2.3%) and non-refugees (2.9%) was higher than the Swedish born (1.4%). Refugees and non-refugee migrants had about a 20% lower risk of all-cause mortality and external causes of mortality compared with Swedish-born individuals. An even greater reduction in suicide risk (aHR 0.51, 95% CI 0.37 to 0.70, and 0.63, 95% CI 0.49 to 0.82 for non-refugees and refugees, respectively) was found. When restricted to those with a mental or somatic disorder, a lower risk of both general and specific mortality was also found among both refugees and non-refugee migrants compared with Swedish-born individuals. Refugees had, however, equal point estimates of all-cause mortality associated with substance misuse disorder and neoplasms as their Swedish-born peers with these disorders. CONCLUSIONS With few exceptions, young migrants with specific mental and somatic disorders have a mortality advantage compared with their Swedish-born peers with the same disorders. Further research on protective factors is warranted.
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Affiliation(s)
- Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Svetlana Filatova
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Syed Ghulam Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alexis Cullen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, King's College London, London, UK
| | - Thomas Dorner
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Katalin Gémes
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ridwanul Amin
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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125
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Haddad M, Young N. Self-harm and suicide: occurrence, risk assessment and management for general nurses. Nurs Stand 2022; 37:71-76. [PMID: 35502573 DOI: 10.7748/ns.2022.e11911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Abstract
Suicide is a tragic event that has traumatic and far-reaching effects on families, friends and healthcare professionals, for whom feelings of guilt, blame and regret are common. Although there have been reductions in suicide rates globally and in the UK over past decades, it remains one of the leading causes of death. Assessing and supporting people who present with self-harm and risk of suicide are essential aspects of all nurses' clinical practice. This article explains the relationship between suicide, self-harm and other risk factors. It also provides guidance for general nurses on evidence-based approaches to managing self-harm and assessing suicide risk collaboratively with service users.
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Affiliation(s)
- Mark Haddad
- Centre for Health Services Research, City University of London School of Health Sciences, London, England
| | - Norman Young
- Early Intervention in Psychosis, Cardiff and Vale University Health Board, Hafan Y Coed, Llandough, Wales
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Saitoh K, Yoshiike T, Kaneko Y, Utsumi T, Matsui K, Nagao K, Otsuki R, Aritake-Okada S, Kadotani H, Kuriyama K, Suzuki M. Associations of nonrestorative sleep and insomnia symptoms with incident depressive symptoms over 1-2 years: Longitudinal results from the Hispanic Community Health Study/Study of Latinos and Sueño Ancillary Study. Depress Anxiety 2022; 39:419-428. [PMID: 35377954 DOI: 10.1002/da.23258] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 01/29/2022] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nonrestorative sleep (NRS), defined as insufficiently rested or refreshed sleep, is considered to play an important role in the development of depression. The aim of this study is to investigate the predictive ability of insomnia-related symptoms, including NRS, for incident depressive symptoms (DEPs) in a longitudinal manner. METHODS We used data of 1196 samples aged 18-64 years who participated in both the Hispanic Community Health Study/Study of Latinos conducted in 2008-2010 and the follow-up study (Sueño Ancillary Study) conducted in 2010-2013. DEPs and insomnia-related symptoms (difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], early morning awakening [EMA], difficulty returning to sleep [DRS], and NRS) were evaluated by the 10-item Center for Epidemiologic Studies Depression Scale and the Women's Health Initiative Insomnia Rating Scale, respectively. A logistic regression analysis was used to evaluate the predictive ability of each insomnia-related symptom at baseline for incident DEPs in couple-years. RESULTS In the univariate logistic regression analysis, all insomnia-related symptoms had significant associations with incident DEPs (DIS, odds ratio [OR] = 1.6; DMS, OR = 1.6; EMA, OR = 1.5; DRS, OR = 1.9; NRS, OR = 2.5). After adjusting for sociodemographic factors and the confounding effects of other insomnia-related symptoms, only NRS (OR = 2.2, 95% confidence interval = 1.4-3.5, p = .001) was significantly associated with incident DEPs. CONCLUSIONS NRS was a risk factor for incident DEPs, which includes a predictive ability for other insomnia-related symptoms. Our results suggest that focusing on NRS is an effective strategy for preventing depression in public health promotions.
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Affiliation(s)
- Kaori Saitoh
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshiyuki Kaneko
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Rei Otsuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Sayaka Aritake-Okada
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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Costanza A, Amerio A, Aguglia A, Serafini G, Amore M, Hasler R, Ambrosetti J, Bondolfi G, Sampogna G, Berardelli I, Fiorillo A, Pompili M, Nguyen KD. Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision? Neurosci Biobehav Rev 2022; 136:104606. [PMID: 35289272 PMCID: PMC8916836 DOI: 10.1016/j.neubiorev.2022.104606] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022]
Abstract
Accumulating scientific and clinical evidence highlighted pathological hyperinflammation as a cardinal feature of SARS-CoV-2 infection and acute COVID-19 disease. With the emergence of long COVID-19 syndrome, several chronic health consequences, including neuropsychiatric sequelae, have gained attention from the public and medical communities. Since inflammatory mediators have also been accredited as putative biomarkers of suicidal ideations and behaviors, hyper- and neuroinflammation might share some colliding points, overlapping and being interconnected in the context of COVID-19. This review aims to provide a summary of current knowledge on the molecular and cellular mechanisms of COVID-19-associated hyper/neuroinflammation with focus on their relevance to the inflammatory hypothesis of suicide development. Subsequently, strategies to alleviate COVID-19 hyper/neuroinflammation by immunomodulatory agents (many of which at experimental stages) as well as psychopharmacologic/psychotherapeutic approaches are also mentioned. While suicide risk in COVID-19 survivors - until now little known - needs further analysis through longitudinal studies, current observations and mechanistic postulates warrant additional attention to this possibly emerging mental health concern.
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Affiliation(s)
- A Costanza
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
| | - A Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - R Hasler
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - J Ambrosetti
- Department of Psychiatry and Department of Emergency, Emergency Psychiatric Unit (UAUP), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - G Bondolfi
- Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), University Hospitals (HUG), Geneva, Switzerland
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - I Berardelli
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - M Pompili
- Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - K D Nguyen
- Tranquis Therapeutics, Palo Alto, CA, USA; Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, USA
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128
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Ranning A, Madsen T, Hawton K, Nordentoft M, Erlangsen A. Transgenerational concordance in parent-to-child transmission of suicidal behaviour: a retrospective, nationwide, register-based cohort study of 4 419 642 individuals in Denmark. Lancet Psychiatry 2022; 9:363-374. [PMID: 35354063 DOI: 10.1016/s2215-0366(22)00042-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Suicidal behaviour runs in families, but the nature of transgenerational concordance needs elucidation. The aim of this study was to examine parent-to-child transmission by investigating whether presence and nature of parental suicidal behaviour was associated with suicidal behaviour in children. METHODS We did a retrospective, nationwide, register-based cohort study in Demark using register data. We included all individuals born after 1953 who were 10 years or older and who were recorded as living in Denmark at some point between Jan 1, 1980, and Dec 31, 2016. Adults listed as living with their child at first registration in the Civil Registration System were considered as parents; later records of different legal parents allowed identification of potential step-parents. Self-reported ethnicity data were not available. Exposure to parental suicide attempt and suicide was identified using information from hospital contacts and causes of death from national registers. The examined outcomes were suicide attempt and death by suicide. We calculated incidence rate ratios (IRRs) and cumulative hazards for children's suicide attempt and suicide, taking into account type of parental suicidal behaviour, child's age of exposure, and sex. FINDINGS In total, 4 419 642 individuals aged 10-63 years were observed during 1980-2016. Of these individuals, 150 222 (3·4%) were exposed to one or more parents with a suicide attempt, 31 564 (0·7%) to at least one parent who died by suicide, and 12 834 (0·3%) to both events. Individuals exposed to parental suicide attempt had higher rates of suicide attempt (IRR 2·72 [95% CI 2·33-3·17]) than individuals exposed to parental suicide (1·77 [1·50-2·09]) when compared with unexposed individuals. Higher rates of suicide were found for individuals exposed to parental suicide (IRR 3·18 [95% CI 2·84-3·58]) than for those exposed to parental suicide attempt (2·37 [2·19-2·57]). The cumulative hazard of suicide attempt was 0·07 for individuals exposed to parental suicide attempt, and the cumulative hazard of suicide was 0·009 for individuals exposed to parental suicide. Individuals exposed to parental suicide had higher odds of violent suicidal methods than those exposed to suicide attempt alone (odds ratio 2·0 [95% CI 1·7-2·3]). INTERPRETATION A concordant pattern of higher rates of the same type of suicidal behaviour as the one of the parents was observed, including type of suicide method. Preventive, family-oriented interventions are warranted to mitigate familial transmission of risk, as are clinical considerations of familial exposure in risk assessment of patients. FUNDING Mental Health Services, Capital Region of Denmark.
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Affiliation(s)
- Anne Ranning
- Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Trine Madsen
- Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, UK; Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Annette Erlangsen
- Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center of Mental Health Research, Australian National University, Canberra, ACT, Australia
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Broder JS, Oliveira J E Silva L, Bellolio F, Freiermuth CE, Griffey RT, Hooker E, Jang TB, Meltzer AC, Mills AM, Pepper JD, Prakken SD, Repplinger MD, Upadhye S, Carpenter CR. Guidelines for Reasonable and Appropriate Care in the Emergency Department 2 (GRACE-2): Low-risk, recurrent abdominal pain in the emergency department. Acad Emerg Med 2022; 29:526-560. [PMID: 35543712 DOI: 10.1111/acem.14495] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 02/07/2023]
Abstract
This second Guideline for Reasonable and Appropriate Care in the Emergency Department (GRACE-2) from the Society for Academic Emergency Medicine is on the topic "low-risk, recurrent abdominal pain in the emergency department." The multidisciplinary guideline panel applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding four priority questions for adult emergency department patients with low-risk, recurrent, undifferentiated abdominal pain. The intended population includes adults with multiple similar presentations of abdominal signs and symptoms recurring over a period of months or years. The panel reached the following recommendations: (1) if a prior negative computed tomography of the abdomen and pelvis (CTAP) has been performed within 12 months, there is insufficient evidence to accurately identify populations in whom repeat CTAP imaging can be safely avoided or routinely recommended; (2) if CTAP with IV contrast is negative, we suggest against ultrasound unless there is concern for pelvic or biliary pathology; (3) we suggest that screening for depression and/or anxiety may be performed during the ED evaluation; and (4) we suggest an opioid-minimizing strategy for pain control. EXECUTIVE SUMMARY: The GRACE-2 writing group developed clinically relevant questions to address the care of adult patients with low-risk, recurrent, previously undifferentiated abdominal pain in the emergency department (ED). Four patient-intervention-comparison-outcome-time (PICOT) questions were developed by consensus of the writing group, who performed a systematic review of the literature and then synthesized direct and indirect evidence to formulate recommendations, following GRADE methodology. The writing group found that despite the commonality and relevance of these questions in emergency care, the quantity and quality of evidence were very limited, and even fundamental definitions of the population and outcomes of interest are lacking. Future research opportunities include developing precise and clinically relevant definitions of low-risk, recurrent, undifferentiated abdominal pain and determining the scope of the existing populations in terms of annual national ED visits for this complaint, costs of care, and patient and provider preferences.
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Affiliation(s)
- Joshua S Broder
- Department of Surgery, Division of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Fernanda Bellolio
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Caroline E Freiermuth
- Department of Emergency Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Richard T Griffey
- Department of Emergency Medicine and Emergency Care Research Core, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Edmond Hooker
- Department of Health Services Administration, Xavier University, Cincinnati, Ohio, USA
| | - Timothy B Jang
- Department of Emergency Medicine, University of California Los Angeles, UCLA Santa Monica Medical Center, Torrance, California, USA
| | - Andrew C Meltzer
- Department of Emergency Medicine, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Angela M Mills
- Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.,Society for Academic Emergency Medicine, Des Plaines, Illinois, USA
| | | | | | - Michael D Repplinger
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Suneel Upadhye
- Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Christopher R Carpenter
- Department of Emergency Medicine and Emergency Care Research Core, Washington University School of Medicine, St. Louis, Missouri, USA.,Society for Academic Emergency Medicine, Des Plaines, Illinois, USA
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Oliveira J. e Silva L, Prakken SD, Meltzer AC, Broder JS, Gerberi DJ, Upadhye S, Carpenter CR, Bellolio F. Depression and anxiety screening in emergency department patients with recurrent abdominal pain: An evidence synthesis for a clinical practice guideline. Acad Emerg Med 2022; 29:615-629. [PMID: 34665903 DOI: 10.1111/acem.14394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recurrent abdominal pain in the emergency department (ED) might represent an opportunity for screening of depression and/or anxiety. METHODS We systematically searched five databases for studies evaluating the effect of screening for depression and/or anxiety in ED patients with recurrent and undifferentiated abdominal pain. Given paucity of direct evidence, we also searched for indirect evidence including studies that assessed prevalence of depression and/or anxiety in EDs (not necessarily recurrent abdominal pain), diagnostic accuracy of screening tools, effectiveness of screening in other settings, and outcomes such as repeat ED visits of patients with abdominal pain who were screened in the ED. Two methodologists evaluated certainty in the evidence using the GRADE approach. RESULTS A total of 4,337 citations were reviewed, and zero studies were found on the effect of screening in patients with recurrent and undifferentiated abdominal pain in the ED. A total of 35 studies were included as relevant indirect evidence. In studies of ED patients with abdominal pain, depression ranged from 10% to 29%, while anxiety ranged from 18% to 50%. False positives appear to be an issue given relatively low specificity of screening tools. One randomized trial including ED patients with vague symptoms evaluated the effect of depression screening on a composite outcome of depression recognition, psychiatric consultation, or referral by the emergency physician (risk ratio = 1.49, 95% confidence interval [CI] = 0.49 to 4.53, very low certainty). One study reported that patients with undifferentiated abdominal pain who screened positive for depression have had increased ED recidivism (odds ratio = 3.17, 95% CI = 1.14 to 8.85, very low certainty). CONCLUSIONS We were unable to identify any evidence that confirms that depression or anxiety screening in ED patients with recurrent and undifferentiated abdominal pain improves outcomes or changes management downstream.
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Affiliation(s)
| | - Steven D. Prakken
- Department of Psychiatry Duke University Health System Durham North Carolina USA
| | - Andrew C. Meltzer
- Department of Emergency Medicine The George Washington University School of Medicine and Health Sciences Washington District of Columbia USA
| | - Joshua S. Broder
- Department of Surgery Division of Emergency Medicine Duke University School of Medicine Durham North Carolina USA
| | | | - Suneel Upadhye
- Department of Emergency Medicine McMaster University Hamilton Ontario Canada
| | - Christopher R. Carpenter
- Department of Emergency Medicine Washington University in St. Louis School of Medicine Emergency Care Research Core St. Louis Missouri USA
| | - Fernanda Bellolio
- Department of Emergency Medicine Mayo Clinic Rochester Minnesota USA
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Rodrigues JE, Martinho A, Santa C, Madeira N, Coroa M, Santos V, Martins MJ, Pato CN, Macedo A, Manadas B. Systematic Review and Meta-Analysis of Mass Spectrometry Proteomics Applied to Human Peripheral Fluids to Assess Potential Biomarkers of Schizophrenia. Int J Mol Sci 2022; 23:ijms23094917. [PMID: 35563307 PMCID: PMC9105255 DOI: 10.3390/ijms23094917] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 01/27/2023] Open
Abstract
Mass spectrometry (MS)-based techniques can be a powerful tool to identify neuropsychiatric disorder biomarkers, improving prediction and diagnosis ability. Here, we evaluate the efficacy of MS proteomics applied to human peripheral fluids of schizophrenia (SCZ) patients to identify disease biomarkers and relevant networks of biological pathways. Following PRISMA guidelines, a search was performed for studies that used MS proteomics approaches to identify proteomic differences between SCZ patients and healthy control groups (PROSPERO database: CRD42021274183). Nineteen articles fulfilled the inclusion criteria, allowing the identification of 217 differentially expressed proteins. Gene ontology analysis identified lipid metabolism, complement and coagulation cascades, and immune response as the main enriched biological pathways. Meta-analysis results suggest the upregulation of FCN3 and downregulation of APO1, APOA2, APOC1, and APOC3 in SCZ patients. Despite the proven ability of MS proteomics to characterize SCZ, several confounding factors contribute to the heterogeneity of the findings. In the future, we encourage the scientific community to perform studies with more extensive sampling and validation cohorts, integrating omics with bioinformatics tools to provide additional comprehension of differentially expressed proteins. The produced information could harbor potential proteomic biomarkers of SCZ, contributing to individualized prognosis and stratification strategies, besides aiding in the differential diagnosis.
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Affiliation(s)
- João E. Rodrigues
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
| | - Ana Martinho
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
| | - Catia Santa
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
| | - Nuno Madeira
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Manuel Coroa
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
| | - Vítor Santos
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
| | - Maria J. Martins
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
- Medical Services, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Carlos N. Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Antonio Macedo
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal
- Correspondence: (A.M.); (B.M.)
| | - Bruno Manadas
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal; (M.C.); (V.S.)
- III Institute for Interdisciplinary Research, University of Coimbra (IIIUC), 3030-789 Coimbra, Portugal
- Correspondence: (A.M.); (B.M.)
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Styles of Coping with Stress among Healthy People and People with Diagnosis of Schizophrenia and Selected Personality Dimensions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095129. [PMID: 35564523 PMCID: PMC9104465 DOI: 10.3390/ijerph19095129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
Background: Schizophrenia is considered a chronic and disabling mental disorder that affects approximately one percent of the world’s population. It is characterized by a variable course and its various symptoms may predominate depending on the characteristics of the person. Aim: Recognition of the personality traits and styles of stress-coping applied by healthy people and people diagnosed with schizophrenia. Methods: The study examined 60 people in total: 30 healthy people between 19 and 58 years old and29 people diagnosed with schizophrenia and 1 person with schizophrenia spectrum disorder between 25 and 72 years old. In the present study we used Personality inventory NEO-FFI by Paul Costa and Robert McCreae, designed to diagnose personality traits described in the five-factor model called “The Big Five” and CISS: Coping Inventory for Stressful Situations by N.S. Endler, J.D.A. Parker, designed to diagnose stress-coping styles.
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Mansuri Z, Reddy A, Vadukapuram R, Thootkur M, Trivedi C. Does Insomnia Increase the Risk of Suicide in Hospitalized Patients with Major Depressive Disorder? A Nationwide Inpatient Analysis from 2006 to 2015. Behav Sci (Basel) 2022; 12:117. [PMID: 35621414 PMCID: PMC9137701 DOI: 10.3390/bs12050117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction. Insomnia is an important symptom associated with major depressive disorder (MDD). In addition, it is one of the risk factors for suicide. Studies have shown the relationship be-tween insomnia and suicidal behavior in patients with MDD. However, this association has not been evaluated in a large sample of hospitalized patients. Objectives. To evaluate the suicidal be-havior in MDD patients with insomnia compared to those without insomnia. Methods. From the National Inpatient Sample (NIS 2006−2015) database using the ICD-9 code, patients’ data were obtained with the primary diagnosis of MDD and comorbid diagnosis of insomnia disorders (MDD+I). These patients were compared with MDD patients without insomnia disorders (MDD−I) by performing a 1:2 match for the primary diagnosis code. Suicidal ideation/attempt da-ta were compared between the groups by multivariate logistic regression analysis. Results. After the diagnostic code matching, 139061 patients were included in the MDD+I group and 276496 patients in the MDD−I group. MDD+I patients were older (47 years vs. 45 years, p < 0.001) com-pared to the MDD−I group. The rate of suicidal ideation/attempt was 56.0% in the MDD+I group and 42.0% in the MDD−I group (p < 0.001). After adjusting for age, sex, race, borderline personal-ity disorders, anxiety disorders, and substance use disorders, ‘insomnia’ was associated with 1.71 times higher odds of suicidal behavior among MDD patients admitted to the hospital. (Odds ratio: 1.71, 95% confidence interval 1.60−1.82, p < 0.001). Conclusions. Insomnia among MDD patients is significantly associated with the risk of suicide. MDD patients with insomnia need to be closely monitored for suicidal behavior.
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Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA;
| | - Ramu Vadukapuram
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Mounica Thootkur
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA;
| | - Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Odessa, TX 79763, USA;
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134
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Topiramate-Induced Suicidal Ideation and Olfactory Hallucinations: A Case Report. REPORTS 2022. [DOI: 10.3390/reports5020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Antiepileptic drugs prescribed in the context of migraine have been reported to be potentially linked with an increased risk of suicidal ideation and behavior. Meta-analyses support the evidence that amongst antiepileptic drugs, Topiramate has the greatest potential for facilitating the occurrence of suicidal ideation and behavior. Studies indicate that this occurs via the increased incidence of mood disorders amongst the population with migraines using Topiramate as a treatment, with a slow and progressive onset of suicidal ideation (if any). We discuss the unique case of a 43-year-old man known to have chronic migraines, who presented with intense rapid-onset suicidal ideation and olfactory hallucinations, three weeks after the introduction of Topiramate for chronic migraines. After a negative extensive investigation panel to rule out common organic diseases, Topiramate was ceased. The suicidal ideation and olfactory hallucinations resolved in less than 24 h without further interventions. This case report highlights that rapid-onset suicidal ideation and olfactory hallucinations could be linked as an unusual side effect to the introduction of Topiramate. The removal of Topiramate from the patient’s pharmacological treatments prevented further psychological distress linked to ego-dystonic suicidal ideation and a resolution of olfactory hallucinations. He was discharged 48 h later.
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Gramaglia C, Martelli M, Scotti L, Bestagini L, Gambaro E, Romero M, Zeppegno P. Attempted Suicide in the Older Adults: A Case Series From the Psychiatry Ward of the University Hospital Maggiore Della Carità, Novara, Italy. Front Public Health 2022; 9:732284. [PMID: 35047468 PMCID: PMC8762240 DOI: 10.3389/fpubh.2021.732284] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/01/2021] [Indexed: 01/24/2023] Open
Abstract
Introduction: As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Our aim was to describe the main socio-demographic and clinical features of a sample of suicide attempters aged 65 years and older, and to assess differences within the sample (men vs. women; patients with vs. without a previous history of suicide attempt; patients with vs. without a previous psychiatric history). Methods: Retrospective study conducted at the Maggiore della Carità University Hospital, Novara, Italy. Results: A higher percentage of female patients in our sample were treated by or referred to mental health services, while a greater percentage of male patients required a prolonged clinical observation in the Emergency Room (ER) or in non-psychiatric wards before psychiatric admission. The percentage of patients without previous psychiatric history taking anxiolytic and sedative medications was 25%. Conclusion: It is likely that different clusters and types of suicide attempters exist. Women in our sample appeared more proactive in asking for help, and more likely to be already treated by or referred to a psychiatric service, suggesting the need to facilitate the access to psychiatric services for the male population aged 65 years and older, or to offer support and care for the non-psychiatric reasons (comorbidities, pain, and loss of autonomy) possibly underlying suicidal behavior in this specific group. The use of medications deserves more attention considering the possible critical diagnostic issues in this age group.
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Affiliation(s)
- Carla Gramaglia
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,S.C. Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Maria Martelli
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Lucia Bestagini
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Eleonora Gambaro
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,S.C. Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Marco Romero
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Patrizia Zeppegno
- Institute of Psychiatry, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,S.C. Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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Irigoyen-Otiñano M, Castro-Herranz S, Romero-Agüit S, Mingote-Adán JC, Garrote-Díaz JM, Matas-Aguilera V, López-Ordoño GJ, Puigdevall-Ruestes M, Alberich S, González-Pinto A. Suicide among physicians: Major risk for women physicians. Psychiatry Res 2022; 310:114441. [PMID: 35183987 DOI: 10.1016/j.psychres.2022.114441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The risk of suicide is related to professional activity. Preliminary data suggest that being in the medical profession increases the risk of suicide in women. The objective of this nationwide study is to compare the death rate of physicians due to suicide with that of the general population and to assess the differences based on gender. MATERIALS AND METHODS All physicians and the general population who died by suicide in Spain between 2005 and 2014, both inclusive, were studied. Between these years, the Spanish population grew from 43,662,613 to 46,455,123 persons and from 199,123 to 238,240 number of doctors. The data relating to the deaths of physicians were extracted from the databases of the General Council of Official Medical Associations (CGCOM) and data related to the general population were obtained from the National Institute of Statistics (INE). The variables included in the analyses are gender, age, specialty, place of residence and death, and causes of death according to the ICD-10. RESULTS The annual mean of physician deaths was 918, with an annual crude rate of 4.8 per 1,000 registered physicians. It is confirmed that physicians have a significantly higher suicide rate (average of 1.3%) than the general population (average of 0.8%) (p = 0.003). The comparison of suicide between men and women doctors is significantly higher in women (X2= 53.068, p<0.001). In addition, if we separate by gender, female physicians have a suicide rate 7.5% higher than women from the general population, although the difference is not significant (X2 = 2.614, p = 0.107). CONCLUSIONS . Suicide is higher among physicians than the general population and affects female physicians significantly more.
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Affiliation(s)
- M Irigoyen-Otiñano
- Psychiatrist, former Secretary General of the Medical Association Lérida. University Hospital Santa Maria, Lérida. Spain.
| | - S Castro-Herranz
- Forensic Doctor, national representative of physicians in Public Administrations at CGCOM. Spain
| | - S Romero-Agüit
- Family Doctor, former President General Council of Medical Associations of Spain (CGCOM). Spain
| | | | - J M Garrote-Díaz
- Family Doctor, former Secretary General of the General Council of Medical Associations of Spain (CGCOM). Spain
| | - V Matas-Aguilera
- Family Doctor, national representative of Urban Primary Health Care at CGCOM. Spain
| | - G J López-Ordoño
- General Surgeon, National representative of Hospitals at CGCOM. Spain
| | | | - S Alberich
- Mathematician, Araba Univesity Hospital-Santiago. Bioaraba. CIBERSAM. UNED. Spain
| | - A González-Pinto
- Psychiatrist. Professor of Psychiatry University of the Basque Country. President of the Spanish Foundation of Mental Health. CIBERSAM. Spain
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Kim YC, Um YH, Kim SM, Kim TW, Seo HJ, Hong SC, Jeong JH. Suicide Risk in Patients With Diabetes Varies by the Duration of Diabetes: The Korea National Health and Nutrition Examination Survey (2019). Psychiatry Investig 2022; 19:326-332. [PMID: 35500906 PMCID: PMC9058264 DOI: 10.30773/pi.2021.0396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The objectives of this study were to investigate the suicide risk in diabetes patients and evaluate the variations in suicide risk by the duration of diabetes using a large population sample in South Korea. METHODS Data from 6,296 adults in the 2019 Korea National Health and Nutrition Examination Survey were included. The suicidal ideation, suicide plans, and suicidal behavior of diabetes patients were compared to the general population. After classifying the patients into ≤1 year, 2 to 9 years, and ≥10 years of diabetes duration, we evaluated the relationship between the duration of diabetes and the suicide risk. RESULTS Diabetes patients had higher prevalences of suicidal ideation (9.1%, p<0.001) and suicide plans (3.6%, p<0.001) than the general population. After adjusting for potential confounding factors, suicide plans (adjusted odds ratio [aOR]=2.926, 95% confidence interval [CI]=1.325-6.463) were significantly associated with diabetes. In the 2 to 9 years group of diabetes patients, we found an increase in the risk of suicidal ideation (aOR=2.035, 95% CI=1.129-3.670), suicide plans (aOR=3.507, 95% CI=1.538-7.996), and suicidal behavior (aOR=7.130, 95% CI=2.035-24.978) after adjusting for the covariates. However, no increases in suicide risk were observed ≤1 year and ≥10 years after diabetes diagnosis. CONCLUSION In adults, diabetes is associated with an increase in suicide risk. Suicide risk in diabetes patients showed an inverted U-shaped depending upon the duration of diabetes.
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Affiliation(s)
- Young-Chan Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Min Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Won Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Jun Seo
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Neural substrates of rewarding and punishing self representations in depressed suicide-attempting adolescents. J Psychiatr Res 2022; 148:204-213. [PMID: 35131589 DOI: 10.1016/j.jpsychires.2022.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/06/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022]
Abstract
Adolescence is a period of plasticity in neural substrates underpinning self-processing. Such substrates are worth studying in depressed youth at risks for suicide because altered neurobiology of self-processing might partially explain differences between suicide attempting youth versus youth who contemplate but do not attempt suicide. Understanding altered substrates of self-processing among depressed adolescents with suicide attempts is critical for developing targeted prevention and treatment. Healthy youth (N = 40), youth with depression and low (N = 33) or high suicide ideation (N = 28), and youth with depression and past suicide attempt (N = 28) heard positive or negative self-descriptors during fMRI and evaluated them from their own, their mother's, classmates', and best friend's perspectives. Lower bilateral caudate activity during positive self-processing distinguished suicide attempting adolescents from all other youth. Higher bilateral caudate activity during negatively valenced self-processing tended to distinguish youth with depression. Blunted reward circuitry during positive vs. negative self-related material tended to distinguish suicide attempting youth, reflecting potentially enhanced behavioral preparedness for punishing vs. rewarding self-relevant cues.
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Alrasheed FK, Alowairdhi YA, Alkharashi YM, Alomar AO, Alqirnas MQ, Alhussaini NA, Albassam A, Almosa AS, Alkhars AZ, Alhelail M. Suicide Attempts by Poisoning: An Experience From a High-Volume Emergency Department. Cureus 2022; 14:e23330. [PMID: 35464598 PMCID: PMC9015061 DOI: 10.7759/cureus.23330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background There has been a tremendous increase in self-poisoning behavior worldwide, with different trends depending on cultural and geographic aspects. Objectives Our study aims to assess the trends, outcomes, and predictors in patients of suicide attempts by poisoning at King Abdulaziz Medical City (KAMC) ED. Materials and methods A retrospective cohort study took place at KAMC. Frequencies and percentages were used to display categorical variables. Minimum, maximum, mean, and SD were used to display continuous variables. Chi-squared test and independent t-test were utilized to test for factors associated with suicidal intention. Results A total of 130 cases were identified. The participants were mostly females (73.8%, n = 96). Most of the participants were pediatric patients (57.7%, n = 75). The most consumed agents were acetaminophen in 59 (45.83%) and non-steroidal anti-inflammatory drugs (NSAIDs) in 22 (16.92%). The ICU admission rate was 8.5% (n = 11). The management for both populations was unspecific, involving observation, supportive measures, and symptomatic treatment. BMI (p < 0.001), gender (p < 0.001), age (p = 0.012), and a history of neuropsychiatric disorders (p < 0.001) were associated factors. Conclusion It is crucial that the trends and risk factors of self-poisoning suicide attempts are identified to provide support to those in need. Several variables of interest were noted since the two most observed agents share several key features, such as accessibility and availability. However, contradicting literature reports warrant further investigation to confirm or negate the evidence.
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Zhang Y, Wang J, Xiong X, Jian Q, Zhang L, Xiang M, Zhou B, Zou Z. Suicidality in patients with primary diagnosis of panic disorder: A single-rate meta-analysis and systematic review. J Affect Disord 2022; 300:27-33. [PMID: 34963642 DOI: 10.1016/j.jad.2021.12.075] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 11/10/2021] [Accepted: 12/19/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND This study investigated the lifetime suicide attempt and ideation rates among patients with panic disorder (PD). METHODS Online databases regarding lifetime suicide attempt and ideation rates in patients with PD were searched up to May 2021. RESULTS The suicide attempt and ideation rates were 0.17 (95% CI: 0.16, 0.18) and 0.23 (95% CI: 0.22, 0.25). The suicide attempt rates among female and male patients were 0.17 (95% CI: 0.14, 0.20) and 0.15 (95% CI: 0.12, 0.19). When PD was comorbid with anxiety, depression, substance abuse, and personality disorders, the suicide attempt rates increased to 0.23 (95% CI: 0.20, 0.26), 0.23 (95% CI: 0.18, 0.27), 0.25 (95% CI: 0.20, 0.31), and 0.25 (95% CI: 0.23, 0.28), respectively. LIMITATIONS The suicide attempt and ideation by age, suicide ideation by sex, and suicide ideation by comorbidity with other mental disorders were passed in our meta-analysis as sample size was small. Stratification analysis on ethnicity, marital status, education levels, resident location, and severity of PD should be considered in the future. CONCLUSION The lifetime suicide ideation and attempt rates in patients with PD were higher than general populations but lower than patients with bipolar or depression. The lifetime suicide attempt rate in female patients was slightly higher than male patients. When PD was comorbid with one other mental illness, the lifetime suicide attempt rate increased by about 50%.
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Affiliation(s)
- Yuan Zhang
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | | | - Xuan Xiong
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Qiu Jian
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Lijuan Zhang
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Miao Xiang
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China; Key Laboratory of psychosomatic medicine, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
| | - Zhili Zou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China; Key Laboratory of psychosomatic medicine, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
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141
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Dutton M, Can AT, Beaudequin D, Jensen E, Jones M, Gallay CC, Schwenn PE, Scherman JK, Yang C, Forsyth G, Lagopoulos J, Hermens DF. Oral ketamine reduces the experience of stress in people with chronic suicidality. J Affect Disord 2022; 300:410-417. [PMID: 35016117 DOI: 10.1016/j.jad.2022.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/29/2021] [Accepted: 01/02/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Stress is prevalent in people experiencing suicidality and is a major contributor to the development of mental disorders. Evidence suggests ketamine shows capacity to reverse stress-induced brain changes. Though stress and ketamine have been explored individually for suicidality, this study is the first to examine ketamine treatment for self-reported stress in adults with chronic suicidality, building on pre-clinical evidence of ketamine's capacity to normalize stress-induced responses and contributing to our understanding of oral ketamine in clinical populations. METHODS Thirty two adult participants (22-72 years; 17 female) with chronic suicidality completed 6 weeks of active treatment, receiving low (0.5 mg/kg - 3.0 mg/kg) doses of oral ketamine once per week, with a 4-week follow-up phase, to assess the effect of ketamine on their perceived stress. Stress was measured via self-report utilizing the Depression Anxiety Stress Scale-21(DASS-21), and analysed at pre-treatment (week 0), post-treatment (week 6) and at follow-up (week 10). RESULTS Repeated measures ANOVA showed a significant reduction in stress (p<.001) post-treatment and Reliable Change Index calculations confirmed this to be clinically significant. Furthermore, those classified as 'prolonged responders' demonstrated a sustained reduction in stress at follow-up (i.e. after 4 weeks of nil ketamine). LIMITATIONS Small sample size, open label design, expectancy, secondary analysis CONCLUSIONS: Ketamine showed the capacity to produce a robust and sustained improvement in stress symptoms, in people with chronic suicidality. Future larger, controlled studies examining treatment suitability in a range of stress related disorders are warranted.
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Affiliation(s)
- Megan Dutton
- Thompson Institute, University of the Sunshine Coast, QLD, Australia.
| | - Adem T Can
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Denise Beaudequin
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Emma Jensen
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Monique Jones
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Cyrana C Gallay
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Paul E Schwenn
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | | | - Cian Yang
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Grace Forsyth
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, QLD, Australia
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Jollant F, Hawton K, Vaiva G, Chan-Chee C, du Roscoat E, Leon C. Non-presentation at hospital following a suicide attempt: a national survey. Psychol Med 2022; 52:707-714. [PMID: 32618240 DOI: 10.1017/s0033291720002305] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A few previous studies suggest that a large number of individuals do not present at hospital following a suicide attempt, complicating recurrence prevention and prevalence estimation. METHODS Data were extracted from a regular phone survey in representative samples of the French population aged 18-75 years old. Five surveys between 2000 and 2017 collected data about the occurrence of a previous suicide attempt and subsequent care contacts. A total of 102,729 individuals were surveyed. Among them, 6,500 (6.4%) reported a lifetime history of suicide attempt. RESULTS Following their last suicide attempt, 39.3% reported they did not present to hospital (53.4% in 18-24 year-olds), with limited changes in rates with time. Risk factors for non-presentation were being male [adjusted odds ratio = 1.3, 95% confidence interval (1.1-1.5)], living with someone [1.2 (1.0-1.4)], being a non-smoker [1.4 (1.2-1.6)], and being younger at time of attempt [0.97 (0.96-0.98) per year]. Of those who did not present to hospital, only 37.7% reported visiting a doctor or a psychiatrist/psychologist after their act v. 67.1% in those who presented to hospital (as a second health contact). In both cases, half disclosed their act to someone else. Prevalence rates of suicide attempts reported in community were 4.6 times higher than those in hospital administrative databases. CONCLUSIONS This survey at a national level confirmed that a large proportion of individuals does not go to the hospital and does not meet any health care professionals following a suicidal act. Assessment of unmet needs is necessary.
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Affiliation(s)
- Fabrice Jollant
- Department of psychiatry, University of Paris (Paris-Descartes University), Paris, France
- GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
- McGill Group for Suicide Studies, McGill University, Montréal, Canada
- CHU de Nîmes, Nîmes, France
| | - Keith Hawton
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
| | - Guillaume Vaiva
- Department of Psychiatry, University of Lille, Lille, France
- Academic Hospital (CHU) of Lille, Lille, France
- SCA Laboratory CNRS-UMR 91-93, Lille, France
| | - Christine Chan-Chee
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
| | - Enguerrand du Roscoat
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
- LAPPS, EA 4386, Université Paris Ouest Nanterre-La Défense, Nanterre, France
| | - Christophe Leon
- National Agency of Public Health (Santé Publique France), Saint-Maurice, France
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143
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Singh R, Mahato S, Khadka S, Basnet P, Bista K, Karki R, Arafat SMY. Newspaper reporting of suicide in Nepal: Quality assessment against World Health Organization media guidelines. Health Sci Rep 2022; 5:e547. [PMID: 35284645 PMCID: PMC8900976 DOI: 10.1002/hsr2.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/24/2022] [Accepted: 02/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Sensible media reporting of suicide is a population-based suicide prevention strategy. However, the quality of media reporting of suicide has not been assessed in Nepal. Objectives We aimed to assess the newspaper reporting status of suicide in Nepal with reference to World Health Organization (WHO) media guidelines for suicide reporting. Method We retrospectively searched eight major newspapers in Nepal between January 2020 and May 2021 and assessed 167 news reports against WHO suicide reporting guidelines. Results Potentially harmful characteristics were found to be reported in both the title and main text of the reports. About half of them mentioned sex (48.5%) and 38.3% mentioned the location of suicide in the title. Of the 167 reports, 74.3%, 95.2%, 34.7%, 92.2%, 98.8%, and 52.7% mentioned the name, sex, occupation, method of suicide, the location of suicide, and life events, respectively, in their main content. On the other hand, only 6% and 2.4% of reports mentioned linkage of suicides with mental illness and substance abuse, respectively. While lesser than 1% of reports narrated educative information regarding suicide prevention, none mentioned contact information for help-seeking for the vulnerable. Conclusion Newspaper reporting of suicide in Nepal poorly adheres to WHO guidelines, substantiated by the high presence of potentially harmful characteristics and negligible presence of potentially helpful characteristics.
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Affiliation(s)
- Rakesh Singh
- Research DepartmentTranscultural Psychosocial Organization (TPO) NepalKathmanduNepal
- Visiting Faculty, Department of Community Medicine and Public HealthKIST Medical CollegeLalitpurNepal
| | - Sharika Mahato
- Monitoring, Evaluation and Research DepartmentPlan International NepalLalitpurNepal
| | | | - Pragyan Basnet
- School of MedicinePatan Academy of Health SciencesLalitpurNepal
| | - Kalendra Bista
- School of MedicinePatan Academy of Health SciencesLalitpurNepal
| | - Ritika Karki
- School of MedicinePatan Academy of Health SciencesLalitpurNepal
| | - S. M. Yasir Arafat
- Department of PsychiatryEnam Medical College and HospitalSavarBangladesh
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Agne NA, Tisott CG, Ballester P, Passos IC, Ferrão YA. Predictors of suicide attempt in patients with obsessive-compulsive disorder: an exploratory study with machine learning analysis. Psychol Med 2022; 52:715-725. [PMID: 32669156 DOI: 10.1017/s0033291720002329] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) are at increased risk for suicide attempt (SA) compared to the general population. However, the significant risk factors for SA in this population remains unclear - whether these factors are associated with the disorder itself or related to extrinsic factors, such as comorbidities and sociodemographic variables. This study aimed to identify predictors of SA in OCD patients using a machine learning algorithm. METHODS A total of 959 outpatients with OCD were included. An elastic net model was performed to recognize the predictors of SA among OCD patients, using clinical and sociodemographic variables. RESULTS The prevalence of SA in our sample was 10.8%. Relevant predictors of SA founded by the elastic net algorithm were the following: previous suicide planning, previous suicide thoughts, lifetime depressive episode, and intermittent explosive disorder. Our elastic net model had a good performance and found an area under the curve of 0.95. CONCLUSIONS This is the first study to evaluate risk factors for SA among OCD patients using machine learning algorithms. Our results demonstrate an accurate risk algorithm can be created using clinical and sociodemographic variables. All aspects of suicidal phenomena need to be carefully investigated by clinicians in every evaluation of OCD patients. Particular attention should be given to comorbidity with depressive symptoms.
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Affiliation(s)
- Neusa Aita Agne
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil
| | - Caroline Gewehr Tisott
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil
| | - Pedro Ballester
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre (RS), Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Ygor Arzeno Ferrão
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil
- Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC), Porto Alegre, Brazil
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145
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Hecking M, Hödlmoser S, Ahmed SB, Carrero JJ. The Other Way Around: Living With Chronic Kidney Disease From the Perspective of Men. Semin Nephrol 2022; 42:122-128. [PMID: 35718360 DOI: 10.1016/j.semnephrol.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A wealth of evidence has suggested sex (biological) and gender (sociocultural) differences in the prevalence, progression, and outcomes of persons with chronic kidney disease. Much of this evidence tends to emphasize differences in which women are disadvantaged, and less attention is paid to findings in which women are better off or similar to men. However, gender medicine recognizes that men and women have different disease determinants, presentation, and attitudes, and it pertains to both sexes. In this review, we revisit chronic kidney disease through the perspective of men, and illustrate a population segment at need of stringent preventative and management strategies.
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Affiliation(s)
- Manfred Hecking
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - Sebastian Hödlmoser
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - Sofia B Ahmed
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Centre for Gender Medicine, Karolinska Institutet, Stockholm, Sweden.
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146
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Arafat SMY, Ahmad AR, Saeed AK, Menon V, Shoib S, Kar SK. Quality of media reporting of suicide in Iraq. Int J Soc Psychiatry 2022; 68:443-448. [PMID: 33736514 DOI: 10.1177/00207640211003928] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mass media has an important role in influencing the suicidal behavior of the general population. However, the quality of news reporting of suicide has not been assessed in Iraq. AIM We aimed to assess the quality of news reports in Iraq while reporting the suicidal behaviors. METHODS The search was done on Google in November and December 2020 with the search term 'suicide news in Iraq' and accessible news reports distributed in Kurdish, Arabic, and English languages were taken out. We scrutinized the news reports to identify the reporting characteristics and compared them with the World Health Organization (WHO) guidelines. RESULTS A total of 130 news reports were analyzed; among them 23.8% were Kurdish, 63.8% were Arabic, and 12.3% were in the English language. About 31.5% of the reports mentioned the name and 40.8% mentioned the occupation. The name of method was mentioned in 88.5%, mono-causality was found in about 34.6%, the term 'suicide' was mentioned in the headline in 94.6%, and method of suicide was mentioned in the headline of about 27.7% of the reports. Only 5.4% of the reports traced mental illness, 6.9% mentioned expert opinion, and none of the reports mentioned prevention program, and educative information. CONCLUSION The study revealed that news reports of suicidal behavior in Iraq are poorly adherent to the WHO reporting guidelines. Further studies are warranted to identify the responsible factors and culture-specific prevention strategies.
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Affiliation(s)
- S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh
| | - Araz Ramazan Ahmad
- Department of Administration, College of Humanities, University of Raparin, Ranya, Iraq.,Department of International Relations & Diplomacy, Faculty of Administrative Sciences and Economics, Tishk International University, Erbil, Iraq
| | | | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Rainawari, Srinagar, Jammu and Kashmir, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Caves Sivaraman JJ, Ranapurwala SI, Proescholdbell S, Naumann RB, Greene SB, Marshall SW. Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017. BMC Psychiatry 2022; 22:104. [PMID: 35144585 PMCID: PMC8832648 DOI: 10.1186/s12888-022-03741-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/28/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There is a well-established need for population-based screening strategies to identify people at risk of suicide. Because only about half of suicide decedents are ever diagnosed with a behavioral health condition, it may be necessary for providers to consider life circumstances that may also put individuals at risk. This study described the alignment of medical diagnoses with life circumstances by identifying suicide typologies among decedents. Demographics, stressful life events, suicidal behavior, perceived and diagnosed health problems, and suicide method contributed to the typologies. METHODS This study linked North Carolina Medicaid and North Carolina Violent Death Reporting System (NC-VDRS) data for analysis in 2020. For suicide decedents from 2014 to 2017 aged 25-54 years, we analyzed 12 indicators of life circumstances from NC-VDRS and 6 indicators from Medicaid claims, using a latent class model. Separate models were developed for men and women. RESULTS Most decedents were White (88.3%), with a median age of 41, and over 70% had a health care visit in the 90 days prior to suicide. Two typologies were identified in both males (n = 175) and females (n = 153). Both typologies had similar profiles of life circumstances, but one had high probabilities of diagnosed behavioral health conditions (45% of men, 71% of women), compared to low probabilities in the other (55% of men, 29% of women). Black beneficiaries and men who died by firearm were over-represented in the less-diagnosed class, though estimates were imprecise (odds ratio for Black men: 3.1, 95% confidence interval: 0.8, 12.4; odds ratio for Black women: 5.0, 95% confidence interval: 0.9, 31.2; odds ratio for male firearm decedents: 1.6, 95% confidence interval: 0.7, 3.4). CONCLUSIONS Nearly half of suicide decedents have a typology characterized by low probability of diagnosis of behavioral health conditions. Suicide screening could likely be enhanced using improved indicators of lived experience and behavioral health.
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Affiliation(s)
- Josie J. Caves Sivaraman
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA ,grid.10698.360000000122483208Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA ,grid.26009.3d0000 0004 1936 7961Present Address: Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina USA
| | - Shabbar I. Ranapurwala
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA ,grid.10698.360000000122483208Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Scott Proescholdbell
- grid.410399.60000 0004 0457 6816North Carolina Department of Health and Human Services, Division of Public Health, Injury and Violence Prevention Branch, Raleigh, North Carolina USA
| | - Rebecca B. Naumann
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA ,grid.10698.360000000122483208Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sandra B. Greene
- grid.10698.360000000122483208Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Stephen W. Marshall
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA ,grid.10698.360000000122483208Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
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A Systematic Review of Risk Factors for Suicide Among Persons Living with HIV (1996-2020). AIDS Behav 2022; 26:2559-2573. [PMID: 35107660 DOI: 10.1007/s10461-022-03591-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2022] [Indexed: 11/01/2022]
Abstract
Persons living with HIV (PWH) are at elevated risk for suicide. We conducted a systematic literature review following PRISMA-P guidelines to examine risk factors associated with suicide as a cause of morbidity among PWH. We searched six electronic databases using search terms (suicide, suicide attempt, self-harm, self-injurious behavior, HIV, AIDS, PWH). We focused on factors that were specific to HIV infection (CD4 count, HIV-1 RNA, and antiretroviral therapy [ART]). The initial search yielded N = 2657 studies. Eligible studies included suicide as an outcome, quantitative study design, and publication in peer-reviewed journals from 1996 through 2020. Fourteen studies met inclusion criteria. PWH share risk factors for suicide found in the general population: psychiatric illness, previous suicide attempt, drug and alcohol misuse. PWH also have HIV-specific risk factors for suicide. HIV diagnosis in the past two years and transmission related to injection drug use were associated with increased risk; HIV-1 RNA, ART, and AIDS-defining illness were not.
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Mourad M, Kazour F, Sleilaty G, Bou Khalil R, El Hage W, Richa S, Sabbagh C. Positive and negative correlates of suicidal ideations and behaviors in the emergency department of a university hospital in Beirut: A cross-sectional comparative study. Encephale 2022; 49:248-253. [DOI: 10.1016/j.encep.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022]
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150
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Cordisco Tsai L, Carlson C, Baylosis R, Hentschel E, Nicholson T, Eleccion J, Ubaldo J, Stanley B, Brown GK, Wainberg M. Practitioner Experiences Responding to Suicide Risk for Survivors of Human Trafficking in the Philippines. QUALITATIVE HEALTH RESEARCH 2022; 32:556-570. [PMID: 34930048 DOI: 10.1177/10497323211062858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human trafficking survivors experience elevated suicide risk in comparison to the general population. Anti-trafficking service providers in the Philippines have identified capacity building in suicide prevention as a critical priority given the insufficient number of trained mental health professionals and lack of culturally adapted evidence-based interventions in the Philippines. We conducted a focused ethnography exploring the experiences of non-mental health professionals working in the anti-human trafficking sector in the Philippines in responding to suicidality among survivors of human trafficking (n = 20). Themes included: emotional burden on service providers, manifestations of stigma regarding suicide, lack of clarity regarding risk assessment, lack of mental health services and support systems, transferring responsibility to other providers, and the need for training, supervision, and organizational systems. We discuss implications for training service providers in the anti-human trafficking sector, as well as cultural adaptation of suicide prevention interventions with human trafficking survivors in the Philippines.
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Affiliation(s)
- Laura Cordisco Tsai
- 33574Harvard John F. Kennedy School of Government, Carr Center for Human Rights Policy, Cambridge, MA, USA
| | - Catherine Carlson
- 8059University of Alabama School of Social Work, Tuscaloosa, AL, USA
| | | | - Elizabeth Hentschel
- Department of Global Health and Population, 1857Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Terriann Nicholson
- New York State Psychiatric Institute, 27424Columbia University Department of Psychiatry, New York, NY, USA
| | | | | | - Barbara Stanley
- New York State Psychiatric Institute, 27424Columbia University Department of Psychiatry, New York, NY, USA
| | - Gregory K Brown
- Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Milton Wainberg
- New York State Psychiatric Institute, 27424Columbia University Department of Psychiatry, New York, NY, USA
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