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Substance use and suicide outcomes among self-injured trauma patients. Drug Alcohol Depend 2021; 226:108906. [PMID: 34315104 DOI: 10.1016/j.drugalcdep.2021.108906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/26/2021] [Accepted: 05/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Research indicates alcohol (AUD) or substance (SUD) use disorders and acute alcohol or drug use serve as risk factors for suicidal behaviors and death both distally and proximally to a suicidal event. However, limited research has investigated these relationships among medically serious suicide attempters at the time of injury without relying on cohorts of substance users only or by examining suicide decedent characteristics. METHODS Data were collected from the National Trauma Data Bank (NTDB) for 2017. The sample comprised patients who engaged in suicidal and self-injurious acts that were medically serious enough to require trauma admission and were tested for alcohol (N = 9,196) or drug (N = 8,121) exposure upon admission. Logistic regression determined relationships between acute alcohol/substance use, presence of AUDs and SUDs and suicide mortality risk, while linear regression evaluated substance conditions and injury severity and length of stay (LOS). RESULTS AUDs (OR = 0.59[0.42-0.83]) and SUDs (OR = 0.66[0.48-0.90]) had reduced odds of death but increased LOS (β = 1.7, p < .001; β = 0.82, p = .024). Blood alcohol concentration (BAC) was positively associated with reduced odds of death (OR = 0.20[0.06-0.61]), injury severity (β = -5.3, p < .001), and LOS (β = -7.5, p < .001). Presence of cocaine (β = -0.80, p = .044) and opioids (β = -1.4, p < .001) were associated lower injury severity, while MDMA (β = 3.6, p = .016) and methamphetamine (β = 1.5, p = .025) were associated with increased injury severity. CONCLUSIONS While higher BAC may be associated with lower odds of mortality during a single high-risk suicide event, substance users may be at increased risk for worse outcomes over time. Targeted interventions should be considered to interrupt and develop healthy alternatives for survivors with substance use conditions.
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102
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A qualitative exploration of young people's experiences of attempted suicide in the context of alcohol and substance use. PLoS One 2021; 16:e0256915. [PMID: 34464418 PMCID: PMC8407575 DOI: 10.1371/journal.pone.0256915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/18/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to explore young people’s experiences of the role and the processes underpinning the use of alcohol and/or other substances in attempts to end their life. Seven young people, aged 16–25 years old, were interviewed using in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse these interviews and develop an understanding of how young people understand their attempted suicide in the context of alcohol and/or other substance use. The analysis identified four superordinate themes reflecting young people’s experiences across the seven interviews. Superordinate themes included: i) The complexity of relationships; ii) The double-edged sword of alcohol and substance use; iii) The straw that broke the camel’s back; and iv) Reflecting on the on-going processes of recovery. The results of this study highlight the complex and multifaceted functions of the consumption of alcohol, and other drugs, in the experiences of young people attempting suicide. Young people described a number of inter and intrapersonal factors which impact upon their suicidal experiences including suicidal ideation and attempts. Participants reported using alcohol and substances as methods of coping with distress, low mood, hearing voices, anxiety and mania. However they also reflected on the impact that this has on their own suicidal ideation and attempts.
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103
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Chikritzhs T, Livingston M. Alcohol and the Risk of Injury. Nutrients 2021; 13:2777. [PMID: 34444939 PMCID: PMC8401155 DOI: 10.3390/nu13082777] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022] Open
Abstract
Globally, almost four and a half million people died from injury in 2019. Alcohol's contribution to injury-related premature loss of life, disability and ill-health is pervasive, touching individuals, families and societies throughout the world. We conducted a review of research evidence for alcohol's causal role in injury by focusing on previously published systematic reviews, meta-analyses and where indicated, key studies. The review summarises evidence for pharmacological and physiological effects that support postulated causal pathways, highlights findings and knowledge gaps relevant to specific forms of injury (i.e., violence, suicide and self-harm, road injury, falls, burns, workplace injuries) and lays out options for evidence-based prevention.
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Affiliation(s)
- Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia;
| | - Michael Livingston
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia;
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia
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104
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Beale EE, Overholser J, Gomez S, Brannam S, Stockmeier CA. The path not taken: Distinguishing individuals who die by suicide from those who die by natural causes despite a shared history of suicide attempt. J Clin Psychol 2021; 78:526-543. [PMID: 34331770 DOI: 10.1002/jclp.23231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/21/2021] [Accepted: 07/17/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study aimed to identify variables that distinguish suicide risk among individuals with previous suicide attempts. METHOD Using psychological autopsy procedures, we evaluated 86 decedents who had at least one lifetime suicide attempt before eventual death by suicide (n = 65) or natural causes (n = 21). RESULTS The Suicide Death group was more likely to be male, to have alcohol in the toxicology report at time of death, and to have a depression diagnosis, while the Natural Cause Death group was more likely to have personality disorder traits, a polysubstance use disorder, higher reported health stress, and an antidepressant in the toxicology report at time of death. Hopelessness and ambivalence were found to distinguish between groups during the 6 months before death. CONCLUSIONS These findings suggest important differences between individuals with a shared history of a suicide attempt who die by suicide versus natural causes.
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Affiliation(s)
- Eleanor E Beale
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - James Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stephanie Gomez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sidney Brannam
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Craig A Stockmeier
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Psychiatry and Human Behavior, Division of Neurobiology and Behavior Research, Translational Research Center (TR415), University of Mississippi Medical Center, Jackson, Mississippi, USA
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105
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Djembi Fossi L, Debien C, Demarty AL, Vaiva G, Messiah A. SUICIDE REATTEMPT IN A POPULATION-WIDE BRIEF CONTACT INTERVENTION TO PREVENT SUICIDE ATTEMPTS - THE VIGILANS PROGRAM, FRANCE. Eur Psychiatry 2021; 64:e57. [PMID: 34266505 PMCID: PMC8516749 DOI: 10.1192/j.eurpsy.2021.2221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Among the postcrisis suicide prevention programmes, brief contact interventions (BCIs) have been proven to be efficient. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls, and sending postcards, according to a predefined algorithm. However, a major problem in suicide prevention is the suicide reattempt, which can lead to final suicide. Here, we analyze the suicide reattempt in VigilanS. Methods The study concerned patients included in VigilanS over the period from January 1, 2015 to December 31, 2018, with an end of follow-up on July 1, 2019. We performed a series of descriptive analyses, survival curves, and regressions. The outcome was the suicide reattempt, and the predictive variables were the characteristics of the patient at entry and during follow-up in VigilanS. Age and sex were considered as adjustment variables. Results A total of 11,879 inclusions occurred during the study period, corresponding to 10,666 different patients, among which 905 reattempted suicide. More than half were primary suicide attempters (53.4%). A significant relationship with suicide reattempt was identified for the following characteristics: being a non-primary suicide attempter, having attempted suicide by voluntary drug intoxication and phlebotomy, alcohol consumption among primary suicide attempters, and having no companion at the emergency room visit among non-primary suicide attempters. Hanging (as suicide method), having made no call to VigilanS were protective factors. Conclusion This study provides us with a valuable insight into the profiles of patients repeating a suicide attempts, which is important for suicide prevention in general.
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Affiliation(s)
- Larissa Djembi Fossi
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.,INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France
| | - Christophe Debien
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | | | - Guillaume Vaiva
- Department of Psychiatry, University Hospital of Lille.,Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences & Cognition, F-59000Lille, France.,Centre National de Ressources et Résilience pour les psychotraumas (Cn2r Lille Paris), Lille, France Department of Psychiatry, University Hospital of Lille
| | - Antoine Messiah
- INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France
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106
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Lee SW. [Epidemiology of Alcoholic Liver Disease in Korea]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 76:55-59. [PMID: 32839366 DOI: 10.4166/kjg.2020.76.2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/03/2022]
Abstract
The harmful use of alcohol is associated with significant medical and socioeconomic burdens responsible for approximately 6% of all deaths worldwide. In Korea, the total alcohol consumption recently decreased slightly from 14.8 L of alcohol per person on average in 2011 to 9.1 L in 2015. On the other hand, over the past 10 years (2007-2017), the rates of monthly alcohol consumption, which is defined as drinking more than once a month, and the rates of high-risk alcohol consumption, defined as drinking more than seven standard drinks twice a week or more, have increased. In particular, the death rate due to alcoholic liver disease was the highest and increasing among those in their 50s who play crucial socioeconomic roles. In addition, the most notable change over the past 10 years has been the increase in alcohol consumption in young women aged between 20 and 39, and the increase in deaths among women due to alcoholic liver disease. In Korea, alcoholic liver disease is ranked 2nd-3rd as the causes of chronic liver disease, liver cirrhosis, and hepatocellular carcinoma, having a significant negative socioeconomic impact.
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Affiliation(s)
- Sung Won Lee
- Department of Internal Medicine, Bucheon St. Mary's hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.,The Catholic University Liver Research Center, Seoul, Korea
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107
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Robins JE, Morley KI, Hayes RD, Ross KR, Pritchard M, Curtis V, Kalk NJ. Alcohol dependence and heavy episodic drinking are associated with different levels of risk of death or repeat emergency service attendance after a suicide attempt. Drug Alcohol Depend 2021; 224:108725. [PMID: 33940325 DOI: 10.1016/j.drugalcdep.2021.108725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Alcohol use is a multidimensional risk factor for suicidal behaviour. However, suicide prevention strategies often take 'one-size-fits-all' approaches to alcohol use, reflecting an evidence base built on unidimensional measures. Latent Class Analysis can use a range of measures to differentiate distinct patterns of alcohol using behaviour and their associated risks. METHODS We analysed Electronic Health Record data from 650 suicidal adults detained for up to 36 h using police powers (Section 136 of the Mental Health Act 1983, amended 2007) to facilitate psychiatric assessment at a Health-Based Place of Safety, a dedicated emergency psychiatric care centre in London, UK. We conducted a Latent Class Analysis of alcohol using behaviours at first detention, and used multivariable logistic regression to estimate the association of each identified latent class with subsequent death or recontact with emergency psychiatric care over a median follow-up of 490 days, adjusting for sex, age and past-year psychiatric diagnosis. RESULTS Three classes of alcohol use were identified: low risk drinkers, heavy episodic drinkers and dependent drinkers. The dependent drinking class had twice the odds of death or recontact with emergency psychiatric care as the low risk drinking class (OR 2.32, 95 %CI 1.62-3.32, p < 0.001). Conversely, the heavy episodic drinking class was associated with lower odds of death or recontact than the low risk drinking class (OR 0.66, 95 %CI 0.53-0.81, p < 0.001). CONCLUSIONS The risk of adverse outcomes after a suicide attempt are not uniform for different alcohol use classes. Clinical assessment and suicide prevention efforts should be tailored accordingly.
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Affiliation(s)
- John E Robins
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.
| | - Katherine I Morley
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; Innovation, Health, and Science, RAND Europe, Westbrook Centre/Milton Rd, Cambridge, CB4 1YG, UK; Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, 207 Bouverie Street, Victoria, 3010, Australia
| | - Richard D Hayes
- Department of Psychological Medicine and NIHR Maudsley Biomedical Research Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Camberwell, London, SE5 8AB, UK
| | - Kezia R Ross
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK
| | - Megan Pritchard
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; CRIS Training & Development Lead, NIHR Maudsley Biomedical Research Centre (BRC), UK; King's College London Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Camberwell, London, SE5 8AB, UK
| | - Vivienne Curtis
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; CRIS Training & Development Lead, NIHR Maudsley Biomedical Research Centre (BRC), UK; Health Education England, 4 Stewart House, 32 Russell Square, Bloomsbury, London, WC1B 5DN, UK
| | - Nicola J Kalk
- National Addiction Centre, King's College London Institute of Psychiatry, Psychology and Neuroscience, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
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108
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Association Between Patterns of Alcohol Use and Short-Term Risk of Suicide Attempt Among Patients With and Without Reported Suicidal Ideation. J Addict Med 2021; 14:e160-e169. [PMID: 32142058 DOI: 10.1097/adm.0000000000000637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the association between patterns of alcohol use and short-term risk of suicide attempt among patients with and without reported suicidal ideation. METHODS Kaiser Permanente Washington electronic health record data were used to identify mental health visits (1/1/2010-6/30/2015) with documented assessments for unhealthy alcohol use (AUDIT-C) and suicidal ideation (PHQ-9 ninth question). Logistic regression fit using generalized estimating equations were used to conduct visit-level analyses, accounting for correlation between individuals' assessments. Separate models evaluated the association between (1) level of alcohol consumption and (2) frequency of heavy episodic drinking (HED), in combination with suicidal ideation (any vs none), with suicide attempt within 90 days following each visit. Primary models adjusted for age, gender, race/ethnicity and visit year. RESULTS Of 59,705 visits (43,706 unique patients), 372 (0.62%) were followed by a suicide attempt within 90 days. The risk of suicide attempt was significantly higher for patients reporting suicidal ideation across all levels of alcohol consumption compared to patients reporting low-level alcohol use and no suicidal ideation, particularly high-level use (OR 9.77, 95% CI, 6.23-15.34). Similarly, risk of suicide attempt was higher for patients reporting suicidal ideation across all levels of HED relative to those reporting no HED or suicidal ideation, particularly HED monthly or more (OR 6.80, 95% CI 4.77-9.72). Among patients reporting no suicidal ideation, no associations were observed. CONCLUSIONS Findings underscore the potential value of offering alcohol-related care to patient reporting suicidal ideation. Additional strategies are needed to identify suicide risk among those reporting no suicidal ideation.
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109
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Maksimova ZV, Maksimov DM. Counseling an alcohol abuse patient. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Alcohol abuse is the regular or episodical alcohol consumption that can cause adverse medical and social consequences without signs of dependence. In Russia, 35% of the population regularly consume alcoholic drinks in very high doses. At the same time, abuse often remains undiagnosed or is not considered a medical problem. However, it is precisely this that causes the massive prevalence of alcohol-related physical and mental health problems, as well as social functioning. The situation can be improved, including through early detection and effective behavioral counseling, especially in primary health care. The World Health Organization recommends a five-step approach to identify and correct alcohol abuse:— identify the alcohol consumption level using the Alcohol Use Disorders Identification Test (AUDIT);— recommend decreasing alcohol consumption;— assess readiness and barriers to cessation or decrease of alcohol use;— help the patient to develop motivations;— continue monitoring and support on follow-up visits.Behavioral counseling for alcohol abuse is provided in a non-judgmental manner as part of the routine medical appointment for any other medical condition. The content of the counseling depends on the motivation of a patient. For hesitant patients who are uncertain about the appropriateness or their ability to reduce alcohol use, a so-called motivational interviewing is conducted, which allows a patient to speak out about the problem and helps to correct unhealthy behaviors. This article is a guideline for health care professionals on brief preventive counseling for alcohol abuse patients.
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110
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Hurzeler T, Buckley NA, Noghrehchi F, Malouf P, Page A, Schumann JL, Chitty KM. Alcohol-related suicide across Australia: a geospatial analysis. Aust N Z J Public Health 2021; 45:394-399. [PMID: 34097331 DOI: 10.1111/1753-6405.13122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/01/2021] [Accepted: 04/01/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The acute effects of alcohol consumption are a major risk factor for suicide. Positive blood alcohol concentrations are present in almost one-third of all suicides at time of death. These suicides are defined as alcohol-related suicides. This cross-sectional study examines the geospatial distribution/clustering of high proportions of alcohol-related suicides and reports on socioeconomic and demographic risk factors. METHODS National Coronial Information System (NCIS) data were used to calculate proportions of suicides with alcohol present at the time of death for each level 3 statistical areas (SA3) in Australia. A density analysis and hotspot cluster analysis were used to visualise and establish statistically significant clustering of areas with higher (hotspots) and lower (coldspots) proportions. Subsequently, socioeconomic and demographic risk factors for alcohol use and suicide were reported on for hot and cold spots. RESULTS Significant clustering of areas with higher proportions of alcohol-related suicide occurred in northern Western Australia, the Northern Territory and Queensland, as well as inland New South Wales and inland Queensland. Clustering of SA3s with significantly lower proportions occurred in major city and inner regional Sydney and Melbourne. Conclusion and implications for public health: Results from this study identify areas in which prevention strategies should target alcohol use and can be used to inform prevention strategy design. Additionally, hotspots and coldspots identified in this study can be used for further analysis to better understand contextual risk factors for alcohol-related suicide.
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Affiliation(s)
- Tristan Hurzeler
- Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, The University of Sydney, New South Wales.,Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, New South Wales
| | - Nicholas A Buckley
- Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, The University of Sydney, New South Wales
| | - Firouzeh Noghrehchi
- Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, The University of Sydney, New South Wales
| | - Peter Malouf
- Discipline of Indigenous Health and Discipline of Addiction Medicine, Centre of Research Excellence in Indigenous Health and Alcohol, Sydney Medical School, The University of Sydney, New South Wales
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, New South Wales
| | - Jennifer L Schumann
- Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, Victoria
| | - Kate M Chitty
- Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, The University of Sydney, New South Wales
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111
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Crouse JJ, Morley KC, Buckley N, Dawson A, Seth D, Monds LA, Tickell A, Kay-Lambkin F, Chitty KM. Online interventions for people hospitalized for deliberate self-harm and problematic alcohol use: Lessons learned from the iiAIM trial. Bull Menninger Clin 2021; 85:123-142. [PMID: 34032460 DOI: 10.1521/bumc.2021.85.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Deliberate self-harm and suicide affect all age groups, sexes, and regions, and their prevention is a global health priority. Acute alcohol misuse and chronic alcohol misuse are strong, modifiable risk factors, and Internet interventions aiming to reduce alcohol misuse and comorbid mental health problems (e.g., depression) are a promising and effective treatment modality. The research team aimed to evaluate the feasibility and effectiveness of an Internet-based comorbidity intervention primarily aiming to reduce alcohol consumption, and secondarily to reduce readmission for deliberate self-harm and improve psychological outcomes among people hospitalized for deliberate self-harm who also engage in problematic alcohol use. However, due to several barriers to recruitment, the trial could not be completed and was discontinued. The authors present a "Lessons Learned" discussion and describe the Internet Intervention for Alcohol Improvement (iiAIM) trial, discuss the key barriers experienced by the research team, and recommend potential solutions that may help future trials in this area.
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Affiliation(s)
- Jacob J Crouse
- University of Sydney, Youth Mental Health and Technology Team, Brain & Mind Centre, Central Clinical School, Sydney, NSW, Australia
| | - Kirsten C Morley
- University of Sydney, Discipline of Addiction Medicine, Central Clinical School, Sydney, NSW, Australia
| | - Nicholas Buckley
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia
| | - Andrew Dawson
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia.,Royal Prince Alfred Hospital, Drug Health Services, Sydney, NSW, Australia
| | - Devanshi Seth
- Royal Prince Alfred Hospital, Drug Health Services, Sydney, NSW, Australia.,University of Sydney, Centenary Institute of Cancer Medicine and Cell Biology, Sydney, NSW, Australia, and the University of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Lauren A Monds
- University of Sydney, Discipline of Addiction Medicine, Central Clinical School, Sydney, NSW, Australia
| | - Ashleigh Tickell
- University of Sydney, Youth Mental Health and Technology Team, Brain & Mind Centre, Central Clinical School, Sydney, NSW, Australia
| | - Frances Kay-Lambkin
- University of Newcastle, Centre for Brain and Mental Health Priority Research Centre, Newcastle, Australia
| | - Kate M Chitty
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia
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112
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Sloan E, Moulding R, Weiner C, Dowling RM, Hall K. A qualitative examination of the relationship between rumination, distress, and dysregulated behaviours in vulnerable young people. Psychol Psychother 2021; 94:322-340. [PMID: 32716586 DOI: 10.1111/papt.12297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Young people accessing mental health treatment in Australia frequently engage in dysregulated behaviours, such as substance misuse, deliberate self-harm (DSH), and binge eating and purging. Rumination has been identified as a correlate of behavioural dysregulation; however, a qualitative examination of the functional relationship between ruminative processes and distress and subsequent engagement in dysregulated behaviours has not yet been conducted. This study aimed to explore the characteristics of rumination in young people and examine how this process relates to engagement in DSH, binge eating and purging, and substance misuse in a sample of treatment-seeking young people. DESIGN A qualitative research methodology was used gain an in-depth understanding of participants' experience of rumination as it relates to their engagement in dysregulated behaviours. METHODS Twelve treatment-seeking young people were interviewed about their experience of rumination in the context of a recently recalled situation where they engaged in a dysregulated behaviour. Interview data were analysed using thematic analysis. RESULTS Themes included the following: (1) triggers to behavioural dysregulation; (2) characteristics and content of rumination; (3) key precipitants to dysregulated behaviours (rumination, distress, and prior ineffective were at managing rumination); and (4) distraction from rumination and regulation of distress as short term, positively reinforcing consequences of dysregulated behaviours, while ongoing cycles of rumination and psychological distress were identified as long-term consequences. CONCLUSIONS DSH, binge/purge behaviours, and substance misuse represent maladaptive ways to distract from intense and pervasive rumination in this cohort of young people. Theoretical and treatment implications pertaining to these findings are discussed. PRACTITIONER POINTS Rumination is a common experience in young people who engage in dysregulated behaviours including deliberate self-harm, binging and purging, and substance misuse Engagement in behavioural dysregulation functions to distract from rumination, which negatively reinforces further engagement in dysregulated behaviours. Interventions in this population should focus on the development of adaptive skills that provide the same level of distraction provided by the physical sensations associated with engaging in a dysregulated behaviour.
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Affiliation(s)
- Elise Sloan
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Deakin University Centre for Drug Use, Addictive and Anti-social Behaviour Research, Burwood, Victoria, Australia
| | - Richard Moulding
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Deakin University Centre for Drug Use, Addictive and Anti-social Behaviour Research, Burwood, Victoria, Australia
| | - Carlye Weiner
- Youth Support and Advocacy Service (YSAS), Fitzroy, Victoria, Australia
| | - Rose-Mary Dowling
- Youth Support and Advocacy Service (YSAS), Fitzroy, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Deakin University Centre for Drug Use, Addictive and Anti-social Behaviour Research, Burwood, Victoria, Australia
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113
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Areán PA, Pratap A, Hsin H, Huppert TK, Hendricks KE, Heagerty PJ, Cohen T, Bagge C, Comtois KA. Perceived Utility and Characterization of Personal Google Search Histories to Detect Data Patterns Proximal to a Suicide Attempt in Individuals Who Previously Attempted Suicide: Pilot Cohort Study. J Med Internet Res 2021; 23:e27918. [PMID: 33955838 PMCID: PMC8138707 DOI: 10.2196/27918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite decades of research to better understand suicide risk and to develop detection and prevention methods, suicide is still one of the leading causes of death globally. While large-scale studies using real-world evidence from electronic health records can identify who is at risk, they have not been successful at pinpointing when someone is at risk. Personalized social media and online search history data, by contrast, could provide an ongoing real-world datastream revealing internal thoughts and personal states of mind. OBJECTIVE We conducted this study to determine the feasibility and acceptability of using personalized online information-seeking behavior in the identification of risk for suicide attempts. METHODS This was a cohort survey study to assess attitudes of participants with a prior suicide attempt about using web search data for suicide prevention purposes, dates of lifetime suicide attempts, and an optional one-time download of their past web searches on Google. The study was conducted at the University of Washington School of Medicine Psychiatry Research Offices. The main outcomes were participants' opinions on internet search data for suicide prediction and intervention and any potential change in online information-seeking behavior proximal to a suicide attempt. Individualized nonparametric association analysis was used to assess the magnitude of difference in web search data features derived from time periods proximal (7, 15, 30, and 60 days) to the suicide attempts versus the typical (baseline) search behavior of participants. RESULTS A total of 62 participants who had attempted suicide in the past agreed to participate in the study. Internet search activity varied from person to person (median 2-24 searches per day). Changes in online search behavior proximal to suicide attempts were evident up to 60 days before attempt. For a subset of attempts (7/30, 23%) search features showed associations from 2 months to a week before the attempt. The top 3 search constructs associated with attempts were online searching patterns (9/30 attempts, 30%), semantic relatedness of search queries to suicide methods (7/30 attempts, 23%), and anger (7/30 attempts, 23%). Participants (40/59, 68%) indicated that use of this personalized web search data for prevention purposes was acceptable with noninvasive potential interventions such as connection to a real person (eg, friend, family member, or counselor); however, concerns were raised about detection accuracy, privacy, and the potential for overly invasive intervention. CONCLUSIONS Changes in online search behavior may be a useful and acceptable means of detecting suicide risk. Personalized analysis of online information-seeking behavior showed notable changes in search behavior and search terms that are tied to early warning signs of suicide and are evident 2 months to 7 days before a suicide attempt.
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Affiliation(s)
- Patricia A Areán
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,ALACRITY Center, University of Washington, Seattle, WA, United States
| | - Abhishek Pratap
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.,Sage Bionetworks, Seattle, WA, United States
| | - Honor Hsin
- Kaiser Permanente, Northern California, CA, United States
| | - Tierney K Huppert
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States
| | - Karin E Hendricks
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States.,University of South Alabama, Mobile, AL, United States
| | - Patrick J Heagerty
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Trevor Cohen
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, United States.,VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Katherine Anne Comtois
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Suicide Prevention and Research, University of Washington, Seattle, WA, United States
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114
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Lasota D, Mirowska-Guzel D, Goniewicz K. Analysis of Suicide Methods and Substances Influencing the State of Consciousness of Their Victims in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4936. [PMID: 34066358 PMCID: PMC8124387 DOI: 10.3390/ijerph18094936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/06/2023]
Abstract
An integral part of the World Health Organization's (WHO) mental health action plan for 2013-2020 is suicide prevention, and a 10% reduction in the suicide rate. A key element of the preventive measures taken is, among other things, limiting access to means enabling and facilitating committing suicide. However, this requires detailed knowledge of community suicide patterns and preferences. Unfortunately, such information is not usually collected, and the recorded method of committing suicide is often imprecise and untrue, which means that such knowledge has limited application in presuicidal prophylaxis. The statistical data on suicides recorded as part of the Police Statistics in Poland during the years 2009-2019 was analyzed. The analysis included suicide deaths and suicide attempts, taking into account the suicide methods and substances influencing the state of consciousness of their victims. The number of suicides in Poland in the analyzed period tended to increase. The most common method of suicide was hanging, and alcohol was the substance influencing the state of consciousness of suicide victims. The statistics for 2017-2019 showed the presence of new methods of suicide, such as taking drugs other than hypnotics, intoxication with narcotic drugs, poisoning with designer drugs, suffocation and self-immolation, as well as new psychoactive substances affecting the state of consciousness of victims, i.e., drugs and narcotic drugs. The effectiveness of actions taken in Poland in the field of suicide prevention does not bring the desired effects, as evidenced by growing number of suicides. This low effectiveness is mainly due to the lack of a national suicide prevention strategy. The effectiveness of these activities may be improved by creating a uniform database of suicides, which is a source of reliable information which will allow the taking of actions aimed at limiting the availability of means enabling and facilitating the committing of suicide. The study aimed to analyze the types of suicide methods and substances influencing the state of consciousness of their victims in Poland in the years covered by the study.
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Affiliation(s)
- Dorota Lasota
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02097 Warsaw, Poland;
| | - Dagmara Mirowska-Guzel
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02097 Warsaw, Poland;
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08521 Dęblin, Poland;
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115
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Williams BM, Kayange L, Purcell L, Gallaher J, Charles A. Self-inflicted injuries: The intersection of mental health and traumatic injury in Malawi. Trop Doct 2021; 51:390-397. [PMID: 33957829 DOI: 10.1177/00494755211013197] [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: 11/17/2022]
Abstract
Self-inflicted injury, the most common form of intentional injury, disproportionately affects low-income countries, but is poorly described in this setting. This retrospective review of the 2008-2018 trauma registry at a referral hospital in Malawi included all victims of intentional injury ≥10 years. Self-inflicted injuries were compared to assaults. The primary outcome was in-hospital mortality. Common mechanisms of self-inflicted injuries were fall from height, poisoning, and penetrating injury. In-hospital mortality from self-inflicted injury was 8.8% vs. 1.9% for assault. Those who died from self-inflicted injury were more often older (median 34 vs. 26 years, p < 0.001), male (91.9% vs. 67.8%, p < 0.001), unemployed (32.8% vs. 6.4%, p < 0.001), and most commonly died by hanging (60%). The odds of in-hospital mortality after self-inflicted injury was four times assault (OR 4.0 [95% CI 1.4-11.5], p = 0.01). The trauma registry proved useful for describing self-inflicted injury in this setting.
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Affiliation(s)
- Brittney M Williams
- Surgery Resident, Department of Surgery, University of North Carolina, Chapel Hill, USA
| | - Linda Kayange
- Surgery Resident, Department of Surgery, 291053Kamuzu Central Hospital, Lilongwe Malawi
| | - Laura Purcell
- Surgery Resident, Department of Surgery, University of North Carolina, Chapel Hill, USA
| | - Jared Gallaher
- Assistant Professor of Surgery, Department of Surgery, University of North Carolina, Chapel Hill, USA
| | - Anthony Charles
- Professor of Surgery, Department of Surgery, University of North Carolina, Chapel Hill, USA.,Professor of Surgery, Department of Surgery, 291053Kamuzu Central Hospital, Lilongwe Malawi
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116
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Aguinaldo LD, Goldstone A, Hasler BP, Brent DA, Coronado C, Jacobus J. Preliminary analysis of low-level alcohol use and suicidality with children in the adolescent brain and cognitive development (ABCD) baseline cohort. Psychiatry Res 2021; 299:113825. [PMID: 33713937 PMCID: PMC8224175 DOI: 10.1016/j.psychres.2021.113825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/21/2021] [Indexed: 12/21/2022]
Abstract
Cross-sectional analyses were conducted in the baseline cohort of the Adolescent Brain and Cognitive Development (ABCD) Study to determine if lifetime low-level alcohol use was associated with an increased likelihood of lifetime suicidality (N=10,773, ages 9-10). Among the lifetime suicide ideation and attempt groups, 37.7% and 36.2% reported lifetime low-level alcohol use, respectively; versus 22.2% in the non-suicidality group. Children reporting lifetime alcohol use (i.e., ≥ a sip) showed a nearly two-fold increase in their odds of lifetime suicidality compared to those with no previous alcohol use. Future prospective research with this cohort will continue to probe alcohol-suicidality associations.
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Affiliation(s)
- Laika D. Aguinaldo
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Aimee Goldstone
- SRI International, Human Sleep Research Program, Menlo Park, California, USA
| | - Brant P. Hasler
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - David A. Brent
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Clarisa Coronado
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Joanna Jacobus
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA.
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117
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Li J, Bornheimer LA, Fernandez L, Dagher J. The Relationships Between Risk-Taking, Depression, and Alcohol Use in the Experience of Suicidal Ideation Among Adults in the General Population. CRISIS 2021; 43:228-235. [PMID: 33890825 DOI: 10.1027/0227-5910/a000775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Risk-taking is associated with suicide among depressed adolescents. In the United States, alcohol is among the most used substances resulting in need for treatment. While alcohol use relates to greater depression and suicidality, less is known about these relationships with risk-taking tendencies, particularly among adult populations. The current study examined suicidal ideation, alcohol use, depression, and risk-taking tendencies among adults 18-65 years old who participated in the 2017 National Survey on Drug Use and Health. Structural equation modeling was used to examine the specific aims in Mplus8. A total of 1,740 (21.4%) participants endorsed suicidal ideation. The model demonstrated good fit and findings indicate increases in alcohol abuse or dependence (b = 0.094, SE = 0.01, p < .001), depression (b = 0.036, SE = 0.01, p < .001), and risk-taking (b = 0.044, SE = 0.01, p < .001) all independently related to increased odds of ideation. Increases in alcohol abuse or dependence (b = 0.210, SE = 0.02, p < .001) and depression (b = 0.026, SE = 0.01, p < .05) also related to elevated risk-taking. Based on the joint significance test, risk-taking tendencies served as a partial mediator, functioning as a mechanism in the relationships between alcohol use, depression, and ideation. Risk-taking thus serves as an important treatment target in the prevention of suicide. Implications for practice and future research are discussed.
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Affiliation(s)
- Juliann Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Lindsay A Bornheimer
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Jenna Dagher
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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118
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Zeifman R, Singhal N, Breslow L, Weissman CR. On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review. ACS Pharmacol Transl Sci 2021; 4:436-451. [PMID: 33860173 PMCID: PMC8033757 DOI: 10.1021/acsptsci.1c00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 12/13/2022]
Abstract
Use of classic psychedelics (e.g., psilocybin, ayahuasca, and lysergic acid diethylamide) is increasing, and psychedelic therapy is receiving growing attention as a novel mental health intervention. Suicidality remains a potential safety concern associated with classic psychedelics and is, concurrently, a mental health concern that psychedelic therapy may show promise in targeting. Accordingly, further understanding of the relationship between classic psychedelics and suicidality is needed. Therefore, we conducted a systematic review of the relationship between classic psychedelics (both non-clinical psychedelic use and psychedelic therapy) and suicidality. We identified a total of 64 articles, including 41 articles on the association between non-clinical classic psychedelic use and suicidality and 23 articles on the effects of psychedelic therapy on suicidality. Findings on the association between lifetime classic psychedelic use and suicidality were mixed, with studies finding positive, negative, and no significant association. A small number of reports of suicide and decreased suicidality following non-clinical classic psychedelic use were identified. Several cases of suicide in early psychedelic therapy were identified; however, it was unclear whether this was due to psychedelic therapy itself. In recent psychedelic therapy clinical trials, we found no reports of increased suicidality and preliminary evidence for acute and sustained decreases in suicidality following treatment. We identify some remaining questions and provide suggestions for future research on the association between classic psychedelics and suicidality.
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Affiliation(s)
- Richard
J. Zeifman
- Department
of Psychology, Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Nikhita Singhal
- Department
of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | - Leah Breslow
- Independent
Researcher, Toronto, Ontario, Canada
| | - Cory R. Weissman
- Department
of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
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119
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Shupp M, Brooks F, Yost L. The Interface of Drug and Alcohol Addiction, Suicide, and Surrender: Implications for Treatment and Approaches. ALCOHOLISM TREATMENT QUARTERLY 2021. [DOI: 10.1080/07347324.2020.1825146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Matthew Shupp
- Department of Counseling and College Student Personnel, Shippensburg University of Pennsylvania, Shippensburg, Pennsylvania, USA
| | - Ford Brooks
- Department of Counseling and College Student Personnel, Shippensburg University of Pennsylvania, Shippensburg, Pennsylvania, USA
| | - Lauren Yost
- Department of Counseling and College Student Personnel, Shippensburg University of Pennsylvania, Shippensburg, Pennsylvania, USA
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120
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Sornpaisarn B, Sornpaisarn S, Rehm J. The association between the time of alcohol drinking and injury risk in Thailand: a cross-sectional emergency department study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:28. [PMID: 33785034 PMCID: PMC8011167 DOI: 10.1186/s13011-021-00365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although the relationship between acute alcohol consumption and injuries is well recognized, studies exploring how the time of day the drinking commences affects alcohol-related injuries have been scarce. This contribution examines the associations between the time at which the drinking began and the duration of the drinking, the volume of alcohol consumed, the injury type, and the blood alcohol concentration (BAC) level. METHOD This study employed a cross-sectional survey, which was conducted in two hospital emergency departments (ED) in Chiangmai Province, Thailand. The sample was composed of 519 injured patients aged 18 years and older. Outcome measures included the BAC and type of injury. Exposures included the quantity of alcohol consumed, the time the drinking commenced, and the pattern of drinking involved. RESULTS The injured patients who drank alcohol within six hours prior to sustaining their injury were more likely to get injured and present themselves at the ED at night (20:00-04:00) compared to those who sustained an injury but did not drink in the hours prior. However, this relationship was only true for unintentional injuries, not intentional ones. The majority of participants consumed their first drink between 16:00 and 20:00. On average, among the 104 patients who drank prior to sustaining an injury, the total amount of alcohol consumed was 6.9 drinks, the duration of drinking was 2.6 h, the rate of drinking was 6.0 drinks/hour, and the BAC was 0.119 gm%. Every drink increased the BAC by 0.012 gm% and each year of increasing age increased the BAC by 0.003 gm%. People who were older, less educated, and drank more frequently tended to have their first drink earlier than other drinkers. An earlier start to their drinking resulted in a faster pace of drinking and a higher BAC. CONCLUSIONS BAC increased with the total amount of alcohol consumed and the age of the drinker. Different groups of people had their first drink at different times of the day, resulting in differences in the rate of drinking, the BAC, the time of injury, and the time they presented to the ED after injury.
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Affiliation(s)
- Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Ontario, M5S 2S1, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, M5T 3M7, Toronto, Ontario, Canada. .,Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, 10400, Bangkok, Thailand.
| | - Sarnti Sornpaisarn
- Faculty of Health Science, McMaster University, 1280 Main Street West, L8S 4L8, Hamilton, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Ontario, M5S 2S1, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, M5T 3M7, Toronto, Ontario, Canada.,World Health Organization / Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, Ontario, Canada.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Martinstraße 52, 20246, Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation
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121
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Choflet A, Davidson J, Lee KC, Ye G, Barnes A, Zisook S. A comparative analysis of the substance use and mental health characteristics of nurses who complete suicide. J Clin Nurs 2021; 30:1963-1972. [PMID: 33763857 DOI: 10.1111/jocn.15749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES To describe the substance use and mental health characteristics of nurses who complete suicide compared to non-nurses. BACKGROUND Nurses are at higher risk of suicide than the general population. The relationship between substance use, mental health and suicide in a large sample of nurses in the USA has not been previously described. DESIGN Retrospective observational quantitative analysis. METHODS Suicide data were retrospectively analysed in the Centers for Disease Control and Prevention National Violent Death Reporting System from 2003 to 2017. Data were compared between nurses who died by suicide (n = 2,306) and non-nurses who died by suicide (n = 185,620) using odds ratios calculations and chi-square test of proportions to detect independent risk factors of suicide completion in nurses. This study followed the STROBE guidelines. RESULTS Significant differences between nurses and non-nurses were found. Among decedents for whom substances were implicated as a cause of death, nurses were far more likely to be positive at the time of death for almost all substance classifications. Both male and female nurses were more likely than non-nurses to have a mental health problem reported. Among both female and male nurses, job problems were more prevalent compared to non-nurses (12.8% and 19.9% versus 7.2% and 11.9%, respectively). Female nurses were more likely to have a physical health problem compared to female non-nurses, male nurses and male non-nurses (26.2% versus 21.3%, 22% and 20.4%). CONCLUSION Unique relationships between substance use and mental health exist among nurses who complete suicide which may offer specific opportunities for interventions to reduce suicide. RELEVANCE TO CLINICAL PRACTICE Efforts to address workplace stress, facilitate self-referral for risky substance use, encourage mental health treatment and reduce the stigma associated with seeking help all offer potential interventions to reduce nurse suicide.
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Affiliation(s)
| | - Judy Davidson
- University of California San Diego, San Diego, CA, USA
| | - Kelly C Lee
- University of California San Diego, San Diego, CA, USA
| | - Gordon Ye
- University of California San Diego, San Diego, CA, USA
| | | | - Sidney Zisook
- University of California San Diego, San Diego, CA, USA
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Araneda N, Sanhueza P, Pacheco G, Sanhueza A. [Suicide in adolescents and young adults in Chile: relative risks, trends, and inequalitiesSuicídio em adolescentes e jovens no Chile: riscos relativos, tendências e desigualdades]. Rev Panam Salud Publica 2021; 45:e4. [PMID: 33815490 PMCID: PMC8007116 DOI: 10.26633/rpsp.2021.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/19/2020] [Indexed: 12/28/2022] Open
Abstract
Objetivo. Describir cuantitativamente el riesgo relativo, la tendencia y la desigualdad geográfica del suicidio en adolescentes y jóvenes entre las regiones de Chile, en el periodo 2000 al 2017. Método. Estudio ecológico poblacional a partir de los registros de defunciones por suicidio. Se estimaron tasas de mortalidad y riesgos relativos (RR) de suicidio por sexo, edad y región. Se estudió la tendencia y desigualdad geográfica del suicidio entre las regiones de Chile; medidas absolutas y relativas de desigualdades geográficas fueron estimadas. Resultados. Entre 2000 y 2017 se registraron 6 292 suicidios en adolescentes y jóvenes en Chile. Las tasas promedio de mortalidad por suicidio en Chile fueron de 8,5; 5,4 y 14.7 por 100 000 en los grupos 10-24, 10-19 y 20-24 años, respectivamente, en el periodo 2000-2017. Las tasas más altas de mortalidad por suicidio se encontraron en las regiones de Aisén, Los Lagos, Magallanes y Los Ríos. El riesgo más alto de suicidio se estimó en los hombres (RR=3,5), los jóvenes (RR=2,7) y en la región de Aisén (RR=2,0). La tasa promedio nacional en el grupo 10-24 años se mantuvo en 8,5 por 100 000 en los periodos 2000-2008 y 2009-2017. La mayor desigualdad geográfica se encontró en hombres de 20-24 años en el periodo 2000-2008. Conclusiones. El suicidio en jóvenes y adolescentes de Chile se ha mantenido sin mayores cambios en el periodo de estudio. Los hombres tienen un mayor riesgo de suicidio que las mujeres. Existen desigualdades geográficas entre las regiones de Chile en el suicidio y son más elevadas en hombres de 20 a 24 años. Se recomienda evaluar y fortalecer los programas de prevención del suicidio en los adolescentes y jóvenes, en especial en las regiones y los grupos poblacionales específicos en situación de mayor vulnerabilidad.
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Affiliation(s)
- Nelson Araneda
- Departamento de Educación, Universidad de La Frontera Temuco Chile Departamento de Educación, Universidad de La Frontera, Temuco, Chile
| | - Pablo Sanhueza
- Departamento de Ingeniería Robótica, Universidad de Maryland College Park Estados Unidos de América Departamento de Ingeniería Robótica, Universidad de Maryland, College Park, Estados Unidos de América
| | - Giovanni Pacheco
- SEREMI de Salud de La Araucanía, Ministerio de Salud de Chile Santiago Chile SEREMI de Salud de La Araucanía, Ministerio de Salud de Chile, Santiago, Chile
| | - Antonio Sanhueza
- Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
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Bailey J, Kalk NJ, Andrews R, Yates S, Nahar L, Kelleher M, Paterson S. Alcohol and cocaine use prior to suspected suicide: Insights from toxicology. Drug Alcohol Rev 2021; 40:1195-1201. [PMID: 33715255 DOI: 10.1111/dar.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/28/2020] [Accepted: 01/24/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study investigates whether there is a relationship between alcohol and cocaine use in deaths where suicide by self-injury is the suspected cause of death. METHODS Adults referred by coroners to the Imperial College London Toxicology Unit for toxicological analysis between 2012 and 2016 were reviewed for inclusion criteria. Those who died by self-injury reasoned to be deliberate were included in the analysis. Femoral blood alcohol concentration (BAC) and presence of cocaine or benzoylecognine (a metabolite of cocaine) in blood and/or urine were tabulated and odds ratios calculated. RESULTS A total of 1722 decedents met inclusion criteria. BAC was ≥50 mg/dL in 29% of decedents. Cocaine was detected in 8.4% of cases. The likelihood of testing positive for cocaine increased with BAC and was most frequent between 100 and 199 mg/dL, consistent with moderate to severe intoxication (odds ratio 5.88, 95% confidence interval 3.80, 9.09; P ≤ 0.001) compared to those with BAC <10 mg/dL. DISCUSSION AND CONCLUSIONS This study demonstrates a correlation between increasing BAC and likelihood of cocaine use prior to suspected suicide, up to a level consistent with severe intoxication. Cocaine use was found in a high proportion of cases relative to the general population reporting regular use. This pattern of drug and alcohol use has previously been given little attention in suicide prevention strategies and clinical prioritisation.
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Affiliation(s)
- James Bailey
- Department of Primary Care, King's College London, London, UK
| | - Nicola J Kalk
- Addictions Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Sarah Yates
- Addictions Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Limon Nahar
- Toxicology Unit, Imperial College London, London, UK
| | - Michael Kelleher
- Addictions Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
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Rizk MM, Herzog S, Dugad S, Stanley B. Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders. CURRENT ADDICTION REPORTS 2021; 8:194-207. [PMID: 33747710 PMCID: PMC7955902 DOI: 10.1007/s40429-021-00361-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 01/05/2023]
Abstract
Purpose of Review Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior. Recent Findings Among people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior. Summary Further research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.
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Affiliation(s)
- Mina M. Rizk
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
- Department of Psychiatry, Faculty of Medicine, Minia University, Egypt, Egypt
| | - Sarah Herzog
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
| | - Sanjana Dugad
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
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Madjar N, Daka D, Zalsman G, Shoval G. Depression symptoms as a mediator between social support, non-suicidal self-injury, and suicidal ideation among Arab adolescents in Israel. SCHOOL PSYCHOLOGY INTERNATIONAL 2021. [DOI: 10.1177/0143034321998741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the current study was to explore whether depression symptoms mediate the relationships between perceptions of social support from three sources; namely parents, teachers, and peers, and non-suicidal self-injury (NSSI) and suicidal ideation. We also tested the interactions between the different sources of support. Focusing on the Arab-Israeli population is unique as it is an ethnic minority characterized with strong familial support, and less access to mental health services compared to the ethnic majority. Adolescents (N = 276; 65.6% girls; mean age 15.1 years) from the Arab minority in northern Israel were sampled (74% response rate). Participants were evaluated using validated scales assessing perceived social support, NSSI and suicidal ideation. Path analysis with Bayesian estimation supported the hypothesized model. Depression symptoms fully mediated the relationships between school-related social support (i.e., teachers and peers) and NSSI, and partially between parents’ support and suicidal ideation. Interactions between the social support sources were not significant, and cluster analysis indicated that each source is independently essential to understand NSSI and suicide ideation. This model emphasizes the importance of school-related factors in adolescents’ particular aspects of mental health, and suggests that one source of social support may not compensate for a lack of another.
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Affiliation(s)
- Nir Madjar
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Doaa Daka
- School of Education, Bar-Ilan University, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Gil Zalsman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel; Department of Psychiatry, Columbia University, New York, USA
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Gal Shoval
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
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Chitty KM, Schumann JL, Moran LL, Chong DG, Hurzeler TP, Buckley NA. Reporting of alcohol as a contributor to death in Australian national suicide statistics and its relationship to post-mortem alcohol concentrations. Addiction 2021; 116:506-513. [PMID: 32621553 DOI: 10.1111/add.15180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/10/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
AIM To describe the assignment of International Classification of Disease (ICD)-10 alcohol codes as underlying or contributory causes of death by the Australian Bureau of Statistics during mortality coding for suicides according to the blood alcohol concentration (BAC) detected at autopsy. DESIGN Population-based case-series descriptive analysis. SETTING AND PARTICIPANTS Data for all alcohol-related (Alc+) suicide deaths (aged 15+) in Australia from 2010-2015 (n = 3132) from the National Coronial Information System. MEASUREMENTS Alc+ suicides were categorised as those with a post-mortem BAC ≥0.05 g/100 mL. The outcome variable was whether the case was assigned an ICD-10 alcohol code (F10.0-F10.9, R78.0, T51, X45 and/or X65). We estimated OR for the assignment of codes in Alc+ suicides using BAC as the key predictor. We also examined several covariates that have been implicated in the risk of Alc+ suicides. FINDINGS An ICD-10 alcohol code was assigned during the mortality coding process in 47.6% (n = 1491) of Alc+ suicides. Higher BAC was associated with higher odds of having a code assigned; cases with a BAC over 0.20 g/100 mL over were twice as likely to have an alcohol code assigned (adjusted OR [AOR] = 2.06, 95% CI = 1.59, 2.67) compared with cases with a BAC of 0.050-0.075 g/100 mL. Compared with New South Wales, higher likelihood of code assignment was found in Northern Territory (AOR = 3.85, 95% CI = 2.32, 6.63) and Western Australia (AOR = 2.89, 95% CI = 2.27, 3.68). Compared with 15-24 year olds, 25-44 (AOR = 0.79, 95% CI = 0.63, 0.99) and 65-84 year olds (AOR = 0.63, 95% CI = 0.43, 0.93) were less likely to have a code assigned. CONCLUSIONS An ICD-10 alcohol code was not assigned as an underlying or contributory cause of death in over half of suicides in Australia (2010-2015) with a BAC ≥0.05 g/100 mL. The higher the BAC detected at autopsy, the more likely cases were to be assigned an alcohol code during the mortality coding process.
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Affiliation(s)
- Kate M Chitty
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, 2006, Australia
| | - Jennifer L Schumann
- Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
| | - Lauren L Moran
- Australian Bureau of Statistics, Health and Vital Statistics Section, Brisbane, Queensland, 4000, Australia
| | - Daniel G Chong
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, 2006, Australia
| | - Tristan P Hurzeler
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, 2006, Australia
| | - Nicholas A Buckley
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, 2006, Australia
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Robins JE, Kalk NJ, Ross KR, Pritchard M, Curtis V, Morley KI. The association of acute alcohol use and dynamic suicide risk with variation in onward care after psychiatric crisis. Drug Alcohol Rev 2021; 40:499-508. [PMID: 33569872 PMCID: PMC8647926 DOI: 10.1111/dar.13231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Despite the association of alcohol use with recurrent suicidal acts, individuals attempting suicide after drinking alcohol face barriers accessing crisis care following emergency assessment, demonstrated by higher odds of inpatient admission for those whose suicide attempt did not feature alcohol. This disparity may be due to suicidality dissipating more rapidly after a suicide attempt involving alcohol. We investigated the effect of acute alcohol use and ongoing suicidality on onward care decisions after emergency assessment. METHODS We analysed electronic health records of 650 suicidal adults detained under Section 136 of the Mental Health Act (1983, amended 2007) for up to 36 h at a London psychiatric emergency care centre. We used logistic regression to estimate the association of acute alcohol use and ongoing suicidality (including their interaction) with admission to psychiatric hospital. RESULTS Fifteen percent of previously intoxicated detainees expressed suicidal intent at detention end, compared to 24% of detainees who had not used alcohol prior to detention. Compared to those who were not previously intoxicated and not suicidal at detention end, acute alcohol use was associated with reduced odds of admission amongst those no longer suicidal (AOR 0.4, 95% CI 0.2, 0.6). Where suicidality persisted, odds of admission rose; however, the magnitude of increase when in combination with prior alcohol use (AOR 3.6, 95% CI 1.9, 7.1) was under half that of when alcohol was not involved (AOR 8.2, 95% CI 3.5, 19.1). DISCUSSION AND CONCLUSIONS Acute alcohol use is associated with transient suicidality, but this only partially accounts for disparities in care following suicide attempts.
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Affiliation(s)
- John E. Robins
- National Addiction CentreKing's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Nicola J. Kalk
- National Addiction CentreKing's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Kezia R. Ross
- National Addiction CentreKing's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Megan Pritchard
- South London and Maudsley NHS Foundation TrustLondonUK
- NIHR Maudsley Biomedical Research CentreLondonUK
- King's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Vivienne Curtis
- South London and Maudsley NHS Foundation TrustLondonUK
- King's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
- School of Psychiatry, Health Education EnglandLondonUK
| | - Katherine I. Morley
- National Addiction CentreKing's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
- Innovation, Health, and Science, RAND EuropeCambridgeUK
- Centre for Epidemiology and BiostatisticsMelbourne School of Global and Population Health, The University of MelbourneMelbourneAustralia
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Alcohol, Other Drugs Use and Mental Health among African Migrant Youths in South Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041534. [PMID: 33562839 PMCID: PMC7915887 DOI: 10.3390/ijerph18041534] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/17/2020] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
This paper was part of a large study that explored suicide among African youths in South Australia. The paper reports perspectives about alcohol and other drugs (AOD) use and mental health among African migrant and refugee youths in South Australia. The study employed a qualitative inquiry, conducting 23 individual interviews and one focus group discussion with eight participants. An acculturative stress model informed data analysis, interpretation and the discussion of the findings that form the current paper. African migrant and refugee youths revealed challenging stressors, including related to cultural, socioeconomic, living conditions, and pre- and post-migration factors that contributed to mental health problems and the use of AOD in their new country. The traumatic loss of family members and social disruption experienced in their countries of origin were expressed as part of factors leading to migration to Australia. While in Australia, African migrant and refugee youths experienced substantial stressors related to inadequate socioeconomic and cultural support, discrimination, poverty, and unemployment. Participants believed that differences in cultural perspectives about AOD use that existed in Africa and Australia also shaped the experiences of social stressors. Additionally, participants believed that these cultural differences and the identified stressors determined AOD use and mental health problems. The findings highlight the need to understand these social and cultural contexts to improve mental health services and help reduce the use of AOD, which, when problematic, can influence the health and integration experiences of these populations.
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Quarshie ENB, Shuweihdi F, Waterman M, House A. Self-harm among in-school and street-connected adolescents in Ghana: a cross-sectional survey in the Greater Accra region. BMJ Open 2021; 11:e041609. [PMID: 33500283 PMCID: PMC7843304 DOI: 10.1136/bmjopen-2020-041609] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana. DESIGN A cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data. SETTING Three contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks). PARTICIPANTS A regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13-21 years. OUTCOME MEASURES Participants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities. RESULTS The lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56). CONCLUSIONS Self-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- Department of Psychology, University of Ghana, Accra, Ghana
- School of Psychology, University of Leeds, Leeds, UK
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Mokros Ł, Nowakowska-Domagała K, Koprowicz J, Witusik A, Pietras T. The association between chronotype and suicidality among students of the medicine and psychology faculties - the mediating role of general mental health indices. Chronobiol Int 2021; 38:509-517. [PMID: 33397172 DOI: 10.1080/07420528.2020.1865393] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of the present study was to evaluate whether anxiety and insomnia symptoms, somatic symptoms, and social dysfunction mediate the link between chronotype and suicidality, as depressive symptoms are known to do, among students of the faculties of Medicine and Psychology. Data from a total of 289 students were eligible for the analysis. The students completed the Suicide Behaviors Questionnaire - Revised, Composite Scale of Morningness, General Health Questionnaire. Single-predictor linear regression models were created to predict suicidality, with a subsequent mediation analysis. A preference toward eveningness was associated with an increase in suicidality Somatic symptoms, anxiety/insomnia, and depressive symptoms fully mediated the relationship between chronotype and suicidality. Depressive symptoms were found to present the strongest effect size of mediation. Social dysfunction was associated with both eveningness and suicidality, but did not play a mediating role. There might be a need to evaluate nonpsychotic mental health indices other than depressive symptoms when assessing the link between suicidality and chronotype among students of the faculties of Medicine and Psychology.
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Affiliation(s)
- Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | | | - Jacek Koprowicz
- Psychiatry Centre of Pabianice, Medical Centre of Pabianice, Pabianice, Poland
| | - Andrzej Witusik
- Grazyna and Kiejstut Bacewicz Memorial Academy of Music in Łódź, Faculty of Composition, Theory of Music, Conducting, Eurhythmics and Music Education, Music Therapy Course, Lodz, Poland
| | - Tadeusz Pietras
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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Escelsior A, Belvederi Murri M, Corsini GP, Serafini G, Aguglia A, Zampogna D, Cattedra S, Nebbia J, Trabucco A, Prestia D, Olcese M, Barletta E, Pereira da Silva B, Amore M. Cannabinoid use and self-injurious behaviours: A systematic review and meta-analysis. J Affect Disord 2021; 278:85-98. [PMID: 32956965 DOI: 10.1016/j.jad.2020.09.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/31/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The increasing availability of high-potency cannabis-derived compounds and the use of synthetic cannabinoids may be responsible for severe side effects like cognitive impairment, psychosis or self-injurious behaviours (SIB). In particular, SIB like non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) raise growing concern as a possible consequence of cannabis use. However, the research to date has not addressed the relationship between cannabinoid use and SIB systematically. METHODS We conducted a systematic review on PubMed up to March 2020, using search terms related to cannabinoids and SIB. RESULTS The search yielded a total of 440 abstracts. Of those, 37 studies published between 1995 and 2020 were eligible for inclusion. Cannabinoid use was significantly associated with SIB at the cross-sectional (OR=1.569, 95%CI [1.167-2.108]) and longitudinal (OR=2.569, 95%CI [2.207-3.256]) level. Chronic use, presence of mental disorders, depressive symptoms, emotional dysregulation and impulsive traits might further increase the likelihood of self-harm in cannabis users. Synthetic cannabinoids may trigger highly destructive SIB mainly through the psychotomimetic properties of these compounds. CONCLUSION Cannabinoid use was associated with an increased prevalence of self-injury and may act as a causative factor with a duration-dependent manner. Emotional regulation and behavioural impulsivity functions might crucially moderate this association. Future studies should further investigate the mechanisms underlying this association, while exploring potential therapeutic applications of substances modulating the endocannabinoid system.
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Affiliation(s)
- Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Pietro Corsini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, 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, 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, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Domenico Zampogna
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Cattedra
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Jacopo Nebbia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Martina Olcese
- Department of Educational Science - Psychology Unit, University of Genoa, Genoa, Italy
| | | | - Beatriz Pereira da Silva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Risk of suicide attempt and suicide in young adult refugees compared to their Swedish-born peers: a register-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2163-2173. [PMID: 33928410 PMCID: PMC8558272 DOI: 10.1007/s00127-021-02099-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/23/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Refugees, especially minors, who often have experienced traumatic events, are a vulnerable group regarding poor mental health. Little is known, however, of their risk of suicidal behaviour as young adults. We aimed to investigate the risk of suicidal behaviour for young adult refugees who migrated as minors. The moderating role of education and history of mental disorders in this association was also investigated. METHODS In this register linkage study, all 19-30-year-old Swedish-born (n = 1,149,855) and refugees (n = 51,098) residing in Sweden on December 31st, 2009 were included. The follow-up period covered 2010-2016. Cox models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The multivariate models were adjusted for socio-demographic, labour market marginalisation and health-related factors. RESULTS Compared to Swedish-born, the risk of suicide attempt was lower for all refugees (HR 0.78, 95% CI 0.70-0.87), and accompanied refugee minors (HR 0.77, 95% CI 0.69-0.87), but estimates did not differ for unaccompanied refugee minors (HR 0.83, 95% CI 0.62-1.10). Low education and previous mental disorders increased the risk of suicide attempt in both refugees and Swedish-born, with lower excess risks in refugees. Findings for suicide were similar to those of suicide attempt. CONCLUSION Young adult refugees have a lower risk of suicidal behaviour than their Swedish-born peers, even if they have low educational level or have mental disorders. Young refugees who entered Sweden unaccompanied do not seem to be equally protected and need specific attention.
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Gonzalez VM, Halvorsen KAS. Mediational Role of Drinking to Cope in the Associations of Depression and Suicidal Ideation with Solitary Drinking in Adults Seeking Alcohol Treatment. Subst Use Misuse 2021; 56:588-597. [PMID: 33673785 DOI: 10.1080/10826084.2021.1883661] [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] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little research on solitary drinking has focused on clinical samples. Previous research in college students has found that depression, suicidal ideation, and drinking to cope with negative affect are associated with drinking in solitary, but not social, contexts. These associations have not been examined among individuals with alcohol use disorder, despite their high rates of depression and suicidal behavior. METHOD To fill this gap in knowledge, the associations of depression and suicidal ideation with solitary and social drinking were examined among 96 individuals seeking alcohol treatment, the majority of whom had alcohol use disorder (97.9%). Multiple mediation models were conducted to examine the mediating effects of two drinking to cope variables (drinking excessively to cope and coping motives) on the associations of depression and suicidal ideation with drinks per month and heavy episodic drinking in social and solitary contexts. RESULTS Significant indirect effects were found for depression and suicidal ideation with solitary drinking variables through greater drinking excessively to cope. No significant indirect effects were found for social drinking variables. However, a positive direct association was found between suicidal ideation and greater social drinks per month that was not mediated by drinking to cope. CONCLUSIONS These findings suggest that greater depression or suicidal ideation, through their effect on greater drinking to cope, are associated with greater solitary drinking in a treatment seeking sample. Drinking context should perhaps be considered in alcohol interventions, particularly when treating individuals suffering from depression or suicidal ideation.
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Affiliation(s)
- Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Kevin A S Halvorsen
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
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Quarshie ENB, Onyeaka HK, Oppong Asante K. Suicidal behaviours among adolescents in Liberia. BMC Psychiatry 2020; 20:572. [PMID: 33256674 PMCID: PMC7706245 DOI: 10.1186/s12888-020-02985-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/23/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Whereas suicide remains in the top 12 leading causes of death among young people aged 10-24 in sub-Saharan Africa, little is known about suicidal behaviours among adolescents in Liberia. We aimed to estimate the 12-month prevalence and describe some of the correlates of suicide behaviours (ideation, planning, and attempt) among school-going adolescents in Liberia. METHODS We analysed data from the 2017 Liberia Global School-based Student Health Survey conducted nationwide among secondary school students. We performed bivariate and multivariable analyses to assess the correlates of suicidal ideation, planning, and attempt in the previous 12 months. RESULTS Of the 2744 students, 26.8% reported suicidal ideation, 36.5% made a specific plan to attempt suicide and 33.7% attempted suicide during the 12 months preceding the survey. In the final adjusted logistic models, bullying victimisation and food insecurity were associated with increased odds of ideation, planning, and attempt. Whereas no factor was uniquely associated with suicidal ideation, having many close friends, and parental monitoring were associated with the increased odds of suicidal planning only. Leisure-time sedentary behaviour was associated with increased odds of suicidal planning and attempt. Cannabis use, alcohol drunkenness, being physically attacked, and parental supervision were uniquely associated with increased odds of suicidal attempt, while parental understanding and having a smaller number of close friends were uniquely associated with reduced odds of suicidal attempt. CONCLUSIONS The relatively high prevalence estimates of suicide behaviours and the multi-contextual nature of the associated factors warrant the need for the design and implementation of universal and multi-level, collaborative targeted intervention efforts towards the prevention of the onset of ideation, planning, and attempt, and the possible transition to deaths by suicide among school-going adolescents in Liberia.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- Department of Psychology, University of Ghana, P.O. Box LG 84, Accra, Ghana. .,School of Psychology, University of Leeds, Leeds, UK.
| | - Henry K. Onyeaka
- Department of Psychiatry, Massachusetts General Hospital/Mclean Hospital, Boston, USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, USA
| | - Kwaku Oppong Asante
- grid.8652.90000 0004 1937 1485Department of Psychology, University of Ghana, P.O. Box LG 84, Accra, Ghana ,grid.412219.d0000 0001 2284 638XDepartment of Psychology, University of the Free State, Bloemfontein, South Africa
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135
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Baldaçara L, Rocha GA, Leite VDS, Porto DM, Grudtner RR, Diaz AP, Meleiro A, Correa H, Tung TC, Quevedo J, da Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 1. Risk factors, protective factors, and assessment. ACTA ACUST UNITED AC 2020; 43:525-537. [PMID: 33111773 PMCID: PMC8555650 DOI: 10.1590/1516-4446-2020-0994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/21/2020] [Indexed: 12/28/2022]
Abstract
Suicide is a global public health problem that causes the loss of more than 800,000 lives each year, principally among young people. In Brazil, the average mortality rate attributable to suicide is approximately 5.23 per 100,000 population. Although many guidelines have been published for the management of suicidal behavior, to date, there are no recent guidelines based on the principles of evidence-based medicine that apply to the reality of suicide in Brazil. The objective of this work is to provide key guidelines for managing patients with suicidal behavior in Brazil. This project involved 11 Brazilian psychiatry professionals selected by the Psychiatric Emergencies Committee (Comissão de Emergências Psiquiátricas) of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. For the development of these guidelines, 79 articles were reviewed (from 5,362 initially collected and 755 abstracts). In this review, we present definitions, risk and protective factors, assessments, and an introduction to the Safety Plan. Systematic review registry number: CRD42020206517
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Affiliation(s)
- Leonardo Baldaçara
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
| | - Gislene A Rocha
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil.,Serviço Especializado em Reabilitação em Deficiência Intelectual, Associação de Pais e Amigos dos Excepcionais, Montes Claros, MG, Brazil
| | - Verônica da S Leite
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Secretaria Municipal de Saúde de Palmas, Palmas, TO, Brazil
| | - Deisy M Porto
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Associação Catarinense de Psiquiatria, Florianópolis, SC, Brazil
| | - Roberta R Grudtner
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Núcleo de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Secretaria Estadual da Saúde, Porto Alegre, RS, Brazil
| | - Alexandre P Diaz
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | - Humberto Correa
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Teng C Tung
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.,Serviços de Pronto Socorro e Interconsultas, IPq, HCFMUSP, São Paulo, SP, Brazil
| | - João Quevedo
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Antônio G da Silva
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Asociación Psiquiátrica de América Latina (APAL)
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136
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Kõlves K, Chitty KM, Wardhani R, Värnik A, de Leo D, Witt K. Impact of Alcohol Policies on Suicidal Behavior: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7030. [PMID: 32992979 PMCID: PMC7578997 DOI: 10.3390/ijerph17197030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022]
Abstract
Alcohol consumption has been found to be related to suicidal behavior at the individual and population level, but there is lack of literature reviews on the effect of alcohol policies on suicidal behavior. Therefore, the aim of the current study is to conduct a systematic literature review of the impact of alcohol policies at the population level on suicidal behavior and ideation. We searched the Cochrane CENTRAL, Cochrane DARE, EMBASE, Medline, ProQuest, PsycINFO, PubMed, SCOPUS, and Web of Science electronic databases in March 2019. Papers analyzing alcohol policies limiting alcohol use and studying suicidal behaviors as an outcome measure were included; we identified 19 papers. Although the methods and effect sizes varied substantially in the studies, reducing alcohol often led to reduction in suicidal behavior. Ecological-level studies predominantly investigated the effect of restrictions on alcohol availability and increased cost of alcohol, and the majority presented a reduction in suicides across Western and Eastern Europe, as well as the US. The majority of studies were rated as unclear risk of bias for a number of domains due to a lack of clear reporting. Policies targeting harmful alcohol consumption may contribute towards a reduction in suicidal behavior at the population level.
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Affiliation(s)
- Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia; (R.W.); (D.d.L.)
| | - Kate M. Chitty
- Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2008, Australia;
| | - Rachmania Wardhani
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia; (R.W.); (D.d.L.)
| | - Airi Värnik
- School of Natural Sciences and Health, Tallinn University, 10120 Tallinn, Estonia;
- Estonian-Swedish Mental Health and Suicidology Institute, 11615 Tallinn, Estonia
| | - Diego de Leo
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia; (R.W.); (D.d.L.)
| | - Katrina Witt
- Orygen, Melbourne, VIC 3052, Australia;
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
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137
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Lasota D, Al-Wathinani A, Krajewski P, Mirowska-Guzel D, Goniewicz K, Hertelendy AJ, Alhazmi RA, Pawłowski W, Khorram-Manesh A, Goniewicz M. Alcohol and the Risk of Railway Suicide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7003. [PMID: 32987939 PMCID: PMC7578964 DOI: 10.3390/ijerph17197003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/20/2022]
Abstract
Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during the period under study. The research was carried out using unidimensional and multidimensional statistical analyses with IBM SPSS Statistics, version 25. Sober suicide victims were statistically significantly older than victims under the influence of alcohol; alcohol concentration was correlated with the age of the victims-the older the victims were, the higher the alcohol concentration. A significantly higher number of deaths attributed to suicide by sober victims was observed in autumn compared to other seasons. Multidimensional analysis showed a statistically significant effect of age and season on the probability of dying by suicide under the influence of alcohol-this probability decreases with the age of the victims and is also significantly lower in autumn. The observed relationship between age and the presence of alcohol in suicide victims can be the cause of railway suicides. Knowledge of the mechanisms of seasonal variability of suicidal behavior can help to develop effective strategies to prevent railway suicides. It is necessary to improve the system of reporting railway suicides, as only reliable statistics provide the possibility of assessing both the scale of the problem and the effectiveness of actions taken.
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Affiliation(s)
- Dorota Lasota
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1b Street, 02097 Warsaw, Poland;
| | - Ahmed Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.-W.); (R.A.A.)
| | - Paweł Krajewski
- Department of Forensic Medicine, Medical University of Warsaw, 50368 Warsaw, Poland;
| | - Dagmara Mirowska-Guzel
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1b Street, 02097 Warsaw, Poland;
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08521 Dęblin, Poland;
| | - Attila J. Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL 33174, USA;
| | - Riyadh A. Alhazmi
- Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia; (A.A.-W.); (R.A.A.)
| | - Witold Pawłowski
- Department of Emergency Medicine, Medical University of Lublin, 20081 Lublin, Poland; (W.P.); (M.G.)
| | - Amir Khorram-Manesh
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 41345 Gothenburg, Sweden;
- Department of Development and Research, Armed Forces Center for Defense Medicine, Västra Frölunda, 42676 Gothenburg, Sweden
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20081 Lublin, Poland; (W.P.); (M.G.)
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138
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Wolford-Clevenger C, Bradizza C, Parrott D, Cropsey KL, Stuart GL. The conditional association of problematic drinking with suicidal ideation by alcohol expectancies. Addict Behav 2020; 108:106436. [PMID: 32353692 PMCID: PMC7282994 DOI: 10.1016/j.addbeh.2020.106436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Theory has identified alcohol expectancies as a facilitating factor in the association between problematic drinking and suicidal ideation. In the first test of this question, we explored whether the impact of problematic drinking on suicidal ideation depended on alcohol expectancies. METHODS We conducted a secondary analysis of cross-sectional, observational, survey data from a convenience sample of 444 individuals court-ordered to domestic violence intervention programs (69.5% non-Hispanic White; 78.6% Male-identified; Mage = 32.53, SDage = 10.10). RESULTS Parallel analysis and exploratory factor analysis revealed a three-factor structure of the Effects of Drinking Alcohol Scale, including alcohol expectancies related to 1) disinhibition and negative mood, 2) positive mood, and 3) physical and cognitive effects. Multiple linear regression employing bootstrapping procedures tested the moderating effects of these expectancies on the association between problematic drinking and suicidal ideation, while controlling for gender and depressive symptoms. Problematic drinking was negatively associated with suicidal ideation at low levels of disinhibition and negative mood expectancies, and this association became more positive as these expectancies increased. Problematic drinking was negatively associated with suicidal ideation at high levels of positive mood and became more positive as these expectancies decreased. DISCUSSION These preliminary findings suggest that expectancies related to the mood-altering and disinhibiting effects of alcohol may play a role in whether problematic drinking facilitates suicidal thinking. Future intensive longitudinal designs are needed to test whether this moderation is replicated during periods of acute alcohol intoxication and when other psychiatric symptoms are controlled.
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Affiliation(s)
- Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Volker Hall L107, 1670 University Blvd., Birmingham, AL 35071, United States.
| | - Clara Bradizza
- School of Social Work, University at Buffalo, Parker Hall, Buffalo, NY 14214-8004, United States.
| | - Dominic Parrott
- Department of Psychology, Georgia State University, P.O Box 5010, Atlanta, GA 30302-5010, United States.
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Volker Hall L107, 1670 University Blvd., Birmingham, AL 35071, United States.
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, 310C Austin Peay Bldg, Knoxville, TN 37996-0900, United States.
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139
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Hasking P, Claes L. Transdiagnostic mechanisms involved in nonsuicidal self-injury, risky drinking and disordered eating: Impulsivity, emotion regulation and alexithymia. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:603-609. [PMID: 30939103 DOI: 10.1080/07448481.2019.1583661] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/20/2018] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
Objective: The aim of the present study was to explore common and differential relationships between nonsuicidal self-injury (NSSI), risky drinking, and disordered eating attitudes and impulsivity, emotion dysregulation, and alexithymia. Methods: We investigated these associations in a sample of 951 college students (79.4% female, Mage = 21.86 years) by means of self-report questionnaires assessing the constructs of interest. Results: Overall, 28% of the students reported a history of NSSI, one third engaged in risky drinking, and less than 5% reported disordered eating symptoms. Negative urgency and difficulties in emotion regulation were both related to each of the three behaviors and can be considered as common transdiagnostic mechanisms. Conclusions: We discuss the implications of transdiagnostic mechanisms involved in these three dysregulated behaviors with respect to their assessment and treatment in college counseling settings.
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Affiliation(s)
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
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140
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Pérez-López FR, Pérez-Roncero GR, López-Baena MT, Santabárbara J, Chedraui P. Hormonal contraceptives and the risk of suicide: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 251:28-35. [PMID: 32470654 DOI: 10.1016/j.ejogrb.2020.04.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the effect of hormonal contraceptive use over the risk of suicide. METHOD Systematic review and meta-analysis of observational studies retrieved from five search engines until September 2019, comparing the use of any hormonal contraceptive versus non-hormonal contraceptive use or no use. Primary outcome was consumed suicide, and secondary outcomes were suicidal attempt and ideation. Random effects meta-analyses with the inverse variance method were used to evaluate the effects of exposure over outcomes. Effect was calculated as risk ratio (RR) with their corresponding 95% confidence interval (CI). Risk of bias was assessed with the Newcastle-Otawa Scale. RESULTS There were no randomized controlled trials concerning suicide and hormonal contraceptive use. Only three cohort studies (n = 184,721 women), that evaluated the primary outcome (consumed suicide), were included in the meta-analysis. Hormonal contraceptive use was associated to a higher risk of consumed suicide (RR = 1.36, 95% CI 1.06 to 1.75, P = 0.015, I2 = 0%). There were no secondary outcomes in at least two cohorts. CONCLUSION This meta-analysis found a positive association between hormonal contraceptive use and consumed suicides. Prior to their use, populations at suicidal risk should be properly evaluated.
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Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza, Faculty of Medicine, Zaragoza, Spain; Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain.
| | | | | | - Javier Santabárbara
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain; Department of Preventive Medicine and Public Health University of Zaragoza, Faculty of Medicine, Zaragoza, Spain
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador; Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción, Asunción, Paraguay
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141
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Lubman DI, Heilbronn C, Ogeil RP, Killian JJ, Matthews S, Smith K, Bosley E, Carney R, McLaughlin K, Wilson A, Eastham M, Shipp C, Witt K, Lloyd B, Scott D. National Ambulance Surveillance System: A novel method using coded Australian ambulance clinical records to monitor self-harm and mental health-related morbidity. PLoS One 2020; 15:e0236344. [PMID: 32735559 PMCID: PMC7394421 DOI: 10.1371/journal.pone.0236344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 07/04/2020] [Indexed: 01/01/2023] Open
Abstract
Self-harm and mental health are inter-related issues that substantially contribute to the global burden of disease. However, measurement of these issues at the population level is problematic. Statistics on suicide can be captured in national cause of death data collected as part of the coroner's review process, however, there is a significant time-lag in the availability of such data, and by definition, these sources do not include non-fatal incidents. Although survey, emergency department, and hospitalisation data present alternative information sources to measure self-harm, such data do not include the richness of information available at the point of incident. This paper describes the mental health and self-harm modules within the National Ambulance Surveillance System (NASS), a unique Australian system for monitoring and mapping mental health and self-harm. Data are sourced from paramedic electronic patient care records provided by Australian state and territory-based ambulance services. A team of specialised research assistants use a purpose-built system to manually scrutinise and code these records. Specific details of each incident are coded, including mental health symptoms and relevant risk indicators, as well as the type, intent, and method of self-harm. NASS provides almost 90 output variables related to self-harm (i.e., type of behaviour, self-injurious intent, and method) and mental health (e.g., mental health symptoms) in the 24 hours preceding each attendance, as well as demographics, temporal and geospatial characteristics, clinical outcomes, co-occurring substance use, and self-reported medical and psychiatric history. NASS provides internationally unique data on self-harm and mental health, with direct implications for translational research, public policy, and clinical practice. This methodology could be replicated in other countries with universal ambulance service provision to inform health policy and service planning.
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Affiliation(s)
- Dan I. Lubman
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
- * E-mail:
| | - Cherie Heilbronn
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Rowan P. Ogeil
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Jessica J. Killian
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Sharon Matthews
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Karen Smith
- Ambulance Victoria, Doncaster, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Emma Bosley
- Queensland Ambulance Service, Brisbane, Queensland, Australia
| | - Rosemary Carney
- New South Wales Ambulance, Rozelle, New South Wales, Australia
| | | | - Alex Wilson
- Ambulance Tasmania, Hobart, Tasmania, Australia
| | - Matthew Eastham
- St John Ambulance Australia (NT) Inc., Casuarina, Northern Territory, Australia
| | - Carol Shipp
- Australian Capital Territory Ambulance Service, Fairbairn, Australian Capital Territory, Australia
| | - Katrina Witt
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Belinda Lloyd
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Debbie Scott
- Turning Point, Eastern Health, Richmond, Victoria, Australia
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
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Albuixech-García R, Juliá-Sanchis R, Fernández Molina MÁ, Escribano S. Impact of the Mental Health Care Continuity-Chain among Individuals Expressing Suicidal Behaviour in a Spanish Sample. Issues Ment Health Nurs 2020; 41:602-607. [PMID: 32255409 DOI: 10.1080/01612840.2019.1692979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Poor coordination between different healthcare services means that the proper follow-up of patients cannot be guaranteed, thus increasing the risk of relapse in cases of attempted suicide. This study describes the sociodemographic variables related to suicidal behaviour in a Spanish sample and analyses how the use of a continued nursing care protocol influences the follow-up of patients who have shown suicidal behaviour. A cohort of 213 patient was identified from the emergency department medical records because of suicide attempters during 2011; 51.6% were included in the intervention group (n = 110) and 48.4% (n = 103) in the control group. We used a specific continuity of care chain protocol with the patients in the intervention group. More than half of all the initial suicide attempts were made by women; 80.3% had a previous history of a mental disorder and 65.7% of the attempts were made by ingesting medications. Significantly more patients in the intervention group attended their first follow-up visit. This study highlights the need to implement protocols that favour the continuity of mental health care processes-especially those designed to treat individuals expressing suicidal behaviour-with the aim of reducing the risk of suicide in them by intensifying their monitoring.
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Affiliation(s)
| | - Rocío Juliá-Sanchis
- Nursing Department, Health Science Faculty, University of Alicante, Alicante, Spain
| | - Miguel Ángel Fernández Molina
- Nursing Department, Health Science Faculty, University of Alicante, Alicante, Spain.,University General Hospital of Alicante, Alicante, Spain
| | - Silvia Escribano
- Nursing Department, Health Science Faculty, University of Alicante, Alicante, Spain
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143
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Chong DG, Buckley NA, Schumann JL, Chitty KM. Acute alcohol use in Australian coronial suicide cases, 2010-2015. Drug Alcohol Depend 2020; 212:108066. [PMID: 32473536 DOI: 10.1016/j.drugalcdep.2020.108066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute use of alcohol is a robust risk factor for suicide, reported in approximately one- to two-fifths of suicide cases. Comparisons of risk factors between suicides with and without prior acute alcohol consumption have not been investigated in Australia. This study addresses the gap by examining individual factors (age, sex, employment status, method of suicide) and environmental factors (month of death, jurisdiction) between alcohol and non-alcohol suicide. METHODS Data for all suicide deaths (aged 15 and over) in Australia were obtained from the National Coronial Information System (NCIS). Blood alcohol concentrations (BAC) were extracted from coronial reports, along with demographic information. Alcohol consumption prior to suicide was assumed if BAC ≥ 0.05 g/100 mL. We compared case characteristics between alcohol related and non-alcohol related suicides using logistic regression. RESULTS 26.7% of suicide deaths in Australia had a BAC ≥ 0.05 g/100 mL. Alcohol use prior to suicide was associated with male gender (adjusted odds ratio [AOR]: 1.14, 95% confidence interval [95%CI]: 1.03, 1.26), being aged between 35-44 years (AOR: 1.26, 95%CI: 1.08, 1.46) and hangings (AOR: 1.53, 95%CI: 1.08, 1.46). Mean suicides per month over the timeframe demonstrated significant seasonality. Mean counts per month for alcohol related suicides peaked in December, compared to a peak in September for non-alcohol related suicides. CONCLUSIONS This study highlights differences between alcohol related and non-alcohol related suicides including sex, age, method of death, time of year and location within Australia. Targeting alcohol related suicide should be a key priority in comprehensive suicide prevention strategies.
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Affiliation(s)
- D G Chong
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia
| | - N A Buckley
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia
| | - J L Schumann
- Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
| | - K M Chitty
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia.
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Chahine M, Salameh P, Haddad C, Sacre H, Soufia M, Akel M, Obeid S, Hallit R, Hallit S. Suicidal ideation among Lebanese adolescents: scale validation, prevalence and correlates. BMC Psychiatry 2020; 20:304. [PMID: 32539735 PMCID: PMC7296775 DOI: 10.1186/s12888-020-02726-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In addition to the unstable political situation, Lebanon had experienced a cycle of wars, local armed conflicts, terrorist attacks, and crises (lack of clean water, recurrent power failure, and waste mismanagement, in addition to the growing number of unemployed people, as the number of Syrian refugees has dramatically increased, and led to competition for jobs with locals. All these factors make the Lebanese population prone to mental disorders, particularly suicide, without clear management policies. This study aims to validate the Columbia-Suicide Severity Rating Scale (CSSRS), and determine the prevalence of suicidal ideation and associated factors among a Lebanese nationally representative sample of adolescents from 9th to 12th grades. METHODS Participants were 1810 adolescents who enrolled in this cross-sectional study (January-May 2019), using a proportionate random sample of schools from all Lebanese Mohafazat. The Columbia-Suicide Severity Rating Scale was used to screen for suicidal ideation. RESULTS The results showed that 28.9% had some type of suicidal ideation [95% CI 26.7-31.1%]. The CSSRS items converged on a one-factor solution, accounting for a total of 85.40% of the variance (αCronbach = 0.966). Higher psychological abuse (Beta = 0.041), child physical abuse (Beta = 0.030), alcohol dependence (Beta = 0.062), social fear (Beta = 0.028), victimization/bullying score (Beta = 0.028), impulsivity (Beta = 0.028) and internet addiction (Beta = 0.010) scores were significantly associated with higher suicidal ideation. Same applies to adolescents whose parents are separated compared to living together (Beta = 0.992) and in females compared to males (0.311). On another hand, a higher age (Beta = - 0.182) was significantly associated with lower suicidal ideation. CONCLUSION This study provides insights about suicidal ideation among Lebanese adolescents and related risk factors, such as child psychological and physical abuse, alcohol use disorders, social fear, bullying and victimization, impulsivity, and internet addiction.
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Affiliation(s)
- Melissa Chahine
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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145
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Sornpaisarn B, Sornpaisarn S, Shield KD, Rehm J. Alcohol use and injury risk in Thailand: A case-crossover emergency department study. Drug Alcohol Rev 2020; 39:539-545. [PMID: 32515099 DOI: 10.1111/dar.13094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS While injuries and alcohol contribute to a large proportion of the disease burden in Thailand, no well-designed underlying study has yet been published. This study aims to evaluate the relationship between acute alcohol consumption and injury risk in Thailand. DESIGN AND METHODS Using the case-crossover design, this study examined 520 injured patients aged 18 years and older from two emergency departments in Meuang District, Chiang-Mai Province, Thailand, from June to August of 2016. The case period was defined as 6 h prior to injury, the two control periods as the same 6-h period at 1 day and 7 days prior to injury. Alcohol exposure and the amount consumed were measured for these periods. RESULTS Twenty percent of injured patients consumed alcohol within the 6 h prior to injury, averaging 6.9 drinks during that time. The odds of injury for those individuals consuming alcoholic beverages was 5.0 (95% confidence interval 3.0, 8.2) times greater compared to non-exposure individuals; every additional drink consumed increased the odds of injury by 1.3 (95% confidence interval 1.2, 1.4). Alcohol use significantly increased the odds of sustaining an unintentional injury, intentional injury inflicted by someone else or experiencing a road traffic injury (among drivers). The dose-response analysis indicated alcohol use significantly increased the risks of unintentional injury and road traffic injuries (among drivers). DISCUSSION AND CONCLUSIONS Exposure to alcohol increased the odds of injury in a dose-dependent fashion; hence, comprehensive, cost-effective strategies should be implemented in Thailand to reduce alcohol exposure, binge drinking and drunk driving.
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Affiliation(s)
- Bundit Sornpaisarn
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Canada.,Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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146
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Affiliation(s)
- Sabrina Brown
- Kentucky Injury Prevention and Research Center, College of Public Health, Department of Epidemiology, University of Kentucky, Lexington, Kentucky
| | - Donna L Schuman
- College of Social Work, University of Kentucky, Lexington, Kentucky
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147
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Goldstone D, Bantjes J, Nel D, Stanbridge J, Lewis I. Alcohol use predicts emergency psychiatric unit admission for non-fatal suicidal behaviour in the Western Cape (South Africa): a case-control study. Int J Psychiatry Clin Pract 2020; 24:163-172. [PMID: 31928103 DOI: 10.1080/13651501.2019.1711419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: We aimed to describe patterns of substance use among patients admitted to an emergency psychiatric unit for non-fatal suicidal behaviour (NFSB) or another psychiatric reason and establish whether there were significant differences in patterns of substance use between the two groups.Methods: We employed a case-control design (N = 50) and collected data about participants' substance use in Cape Town, South Africa. Data were analysed using Chi-square and Mann-Whitney tests, factor analysis, and logistic regressions.Results: Prevalence of lifetime Alcohol Use Disorder (AUD) was 60% in the NFSB group and 28% in the control group. 12% of the NFSB group and 20% of the control group had a lifetime Tobacco Use Disorder. Prevalence of lifetime illicit Substance Use Disorder was 44% in the NFSB group and 60% in the control group. Hospital admission for NFSB was associated with: any past 24-hour alcohol use; quantity of past 24-hour alcohol use; quantity of past-month alcohol use; lifetime AUD; past 12-month AUD; and current AUD; and was not associated with the use of any other substances (p<.05). Past 12-month AUD was the best predictor of hospital admission for NFSB, controlling for, respectively, any past 24-hour alcohol use (aOR = 13.33, p = .023) and quantity of past 24-hour alcohol use (aOR = 9.01, p = .022)Conclusions: Patients admitted to emergency psychiatric units for NFSB have increased needs for the treatment of AUDs compared to patients admitted for another psychiatric emergency. Findings support calls for interventions to prevent NFSB among psychiatric patients with a history of AUD.Key pointsRates of substance use among patients admitted to emergency psychiatric units in South Africa were high compared to the general population.Hazardous alcohol use was uniquely associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.Tobacco use and illicit substance use were not associated with hospital admission for non-fatal suicidal behaviour compared to another psychiatric emergency.The association between hazardous alcohol use and hospital admission for non-fatal suicidal behaviour did not appear to be affected by demographic variables.Patients admitted to hospital for non-fatal suicidal behaviour have increased needs for the treatment of alcohol use disorders compared to other psychiatric patients.
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Affiliation(s)
- Daniel Goldstone
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Daan Nel
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Jessica Stanbridge
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ian Lewis
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Ryan EP, Oquendo MA. Suicide Risk Assessment and Prevention: Challenges and Opportunities. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:88-99. [PMID: 33162846 DOI: 10.1176/appi.focus.20200011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Despite increased access to mental health care for the previously uninsured and expanding evidence-based treatments for mood, anxiety, psychotic, and substance use disorders, suicide is on the rise in the United States. Since 1999, the age-adjusted suicide rate in the United States has increased 33%, from 10.5 per 100,000 standard population to 14.0. As of yet, there are no clinically available biomarkers, laboratory tests, or imaging to assist in diagnosis or the identification of the suicidal individual. Suicide risk assessment remains a high-stakes component of the psychiatric evaluation and can lead to overly restrictive management in the name of prevention or to inadequate intervention because of poor appreciation of the severity of risk. This article focuses primarily on suicide risk assessment and management as a critical first step to prevention, given the fact that more research is needed to identify precision treatments and effective suicide prevention strategies. Suicide risk assessment provides the clinical psychiatrist with an opportunity for therapeutic engagement with the ultimate goals of relieving suffering and preventing suicide.
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Affiliation(s)
- Eileen P Ryan
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus (Ryan); and Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oquendo)
| | - Maria A Oquendo
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus (Ryan); and Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oquendo)
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Perez J, Beale E, Overholser J, Athey A, Stockmeier C. Depression and alcohol use disorders as precursors to death by suicide. DEATH STUDIES 2020; 46:619-627. [PMID: 32238058 DOI: 10.1080/07481187.2020.1745954] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The combined presence of depression with alcohol abuse can increase suicide risk. We used psychological autopsy to evaluate 101 individuals who died by suicide, to understand relationships between stressful life events, alcohol abuse, and depression. As compared to suicidal adults with depression only, individuals meeting criteria for both a depressive disorder and alcohol use disorder tended to be younger and experienced higher rates of stressful life events during the six months prior to death. Alcohol abuse likely influences interpersonal conflict, financial distress, and legal problems. Interventions focusing on managing life problems may help to reduce suicide risk.
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Affiliation(s)
- Jalessa Perez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Eleanor Beale
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - James Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alison Athey
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Craig Stockmeier
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Psychiatry and Human Behavior, Division of Neurobiology and Behavior Research, Translational Research Center (TR415), University of Mississippi Medical Center, Cleveland, Ohio, USA
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