151
|
Kim SM, Han DH, Trksak GH, Lee YS. Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents. ANXIETY STRESS AND COPING 2014; 27:439-54. [PMID: 24344782 DOI: 10.1080/10615806.2013.876010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12-19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior "drinking alcoholic beverages" and "smoking cigarettes" were positively associated with suicidal ideation. "Watching TV," "playing online/mobile games," and "sleeping" were negatively associated with suicidal ideation in both groups. In males, "engaging in sports" was negatively related to suicidal ideation. In females, "venting by talking to others" and "eating" were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.
Collapse
Affiliation(s)
- Sun Mi Kim
- a Department of Psychiatry, College of Medicine , Chung-Ang University , 102 Heukseok-ro, Dongjak-gu 156-755 , Seoul , Korea
| | | | | | | |
Collapse
|
152
|
Eskin M, Palova E, Krokavcova M. Suicidal behavior and attitudes in Slovak and Turkish high school students: a cross-cultural investigation. Arch Suicide Res 2014; 18:58-73. [PMID: 24350593 DOI: 10.1080/13811118.2013.803448] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicidal behavior and its variation across social contexts are of importance for the science of suicidology. Due to its special character controlled experimental studies on suicide are ruled out for ethical reasons. Cross-cultural studies may throw light on the etiology of both suicidal behavior and its cross-cultural variation. The present study compared suicidal behavior and attitudes in 423 Slovak and 541 Turkish high school students by means of a self-report questionnaire. The two groups reported similar percentages (Slovak = 36.4%; Turkish = 33.8%) of lifetime, past 12-months or current suicidal ideation but significantly more Turkish (12.2%) than Slovak (4.8%) students reported lifetime or past 12-months suicide attempts. Slovak adolescents displayed more liberal and permissive attitudes toward suicide, while those of Turkish adolescents were more rejecting. Turkish students rated themselves to be more religious and hence they believed to a greater extent that suicidal persons would be punished in a life after death than their Slovak peers. However, attitudes of Turkish students toward an imagined suicidal close friend were more accepting than the attitudes of Slovak students. Comparison of suicidal and nonsuicidal students revealed that those reporting suicidal ideation or attempts were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal ones. The results from this study suggest that cultural factors play a role in suicidal behavior, attitudes and reactions in a predicted direction.
Collapse
|
153
|
Kapusta ND, Fegert JM, Haring C, Plener PL. Psychotherapeutische Interventionen bei suizidalen Jugendlichen. PSYCHOTHERAPEUT 2013. [DOI: 10.1007/s00278-013-1027-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
154
|
Stallard P, Spears M, Montgomery AA, Phillips R, Sayal K. Self-harm in young adolescents (12-16 years): onset and short-term continuation in a community sample. BMC Psychiatry 2013; 13:328. [PMID: 24294921 PMCID: PMC4219511 DOI: 10.1186/1471-244x-13-328] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/21/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To investigate the prevalence of self-harm in young adolescents and factors associated with onset and continuity over a one year period. METHOD Prospective longitudinal study. Participants were young adolescents (n = 3964) aged 12-16 years attending 8 secondary schools in the Midlands and South West of England. RESULTS Over a one year period 27% of young adolescents reported thoughts of self-harm and 15% reported at least one act of self-harm. Of those who self-harmed, less than one in five (18%) had sought help for psychological problems of anxiety or depression. Compared with boys, girls were at increased risk of developing thoughts (OR 1.61, 95% CI 1.26-2.06) and acts (OR 1.40, 95% CI 1.06-1.84) of self-harm, particularly amongst those girls in school year 9 (aged 13/14, thoughts adjusted Odds Ratio (aOR) 1.97, 95% CI 1.27-3.04; acts aOR 2.59, 95% CI 1.52-4.41). Of those reporting thoughts of self-harm at baseline, 60% also reported these thoughts at follow-up. Similarly 55% of those who reported an act of self-harm at baseline also reported that they had self-harmed at follow-up. Insecure peer relationships increased the likelihood that boys and girls would develop self-harming behaviours, as did being bullied for boys. Low mood was associated with the development of self-harming thoughts and behaviours for boys and girls, whilst a strong sense of school membership was associated with a reduced risk of developing thoughts of self-harm for boys and increased the likelihood of self-harming thoughts and behaviours ceasing for girls. CONCLUSION Self harm in young adolescents is common with one in four reporting self-harming thoughts and one in six engaging in self-harming behaviour over a one year period. Self-harm is already established by 12/13 years of age and for over half of our sample, self-harming thoughts and behaviour persisted over the year. Secure peer and strong school relationships were associated with less self-harm. Few seek help for psychological problems, suggesting a need to increase awareness amongst all professionals who work with young adolescents about self-harm and associated risk factors.
Collapse
Affiliation(s)
- Paul Stallard
- Department of Health, Child and Adolescent Mental Health Research Group, University of Bath, 22-23, Eastwood BA2 7AY, UK.
| | - Melissa Spears
- NIHR Research Methods Training Fellow, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alan A Montgomery
- Medical Statistics and Clinical Trials, Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Rhiannon Phillips
- Department of Health, Child and Adolescent Mental Health Research Group, University of Bath, 22-23, Eastwood BA2 7AY, UK,Institute of Primary Care & Public Health, Cardiff University, Cardiff, UK
| | - Kapil Sayal
- Division of Psychiatry and Applied Psychology, Institute of Menal Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
155
|
Kim JH, Park EC, Cho WH, Park CY, Park JY, Choi WJ, Chang HS. Association between total sleep duration and suicidal ideation among the Korean general adult population. Sleep 2013; 36:1563-72. [PMID: 24082316 DOI: 10.5665/sleep.3058] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Examine the association between sleep duration and suicidal ideation in Korean adults. DESIGN Cross-sectional survey. SETTING Data obtained by the Korea National Health and Nutrition Examination Survey IV (2007-2009) using a rolling sampling design involving a complex, stratified, multistage, and probability-cluster survey of civilian non-institutionalized Korean residents. PARTICIPANTS A total of 15,236 subjects (6,638 males and 8,598 females) ≥ 19 years old. MEASUREMENTS AND RESULTS The weighted prevalence of self-reported short sleep duration (≤ 5 h/day) was 11.7% in males and 15% in females, and of long sleep duration (≥ 9 h/day) was 6.7% in males and 8.9% in females. A U-shaped relationship existed, with both short and long sleep durations associated with a higher suicidal ideation risk. Multiple logistic regression analysis was used to analyze the relationship between sleep duration and suicidal ideation, adjusting for sociodemographic factors, health behavior, and health status. After controlling for covariates, people with short sleep were 38.1% more likely to have suicidal ideation (OR = 1.381, 95% CI 1.156-1.650) than people with sleep duration of 7 h/day. Suicidal ideation was 1.196 times higher (95% CI: 0.950-1.507) in long-sleeping people than people sleeping 7 h/day, although statistically not significant. Inclusion of depressive mood (a potential confounder) in multiple logistic regression models attenuated but did not eliminate the sleep duration/suicidal ideation association. LIMITATIONS Sleep duration and suicidal ideation were assessed only by self-report. CONCLUSIONS The sleep duration/suicidal ideation relationship is U-shaped in the Korean adult population. Self-reported habitual sleep duration may be a useful behavioral indicator for both individual and societal suicidal ideation risk.
Collapse
Affiliation(s)
- Jae-Hyun Kim
- Department of Public Health, Yonsei Univeristy, Seoul, Korea ; Institute of Health Services Research, Yonsei Univeristy, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
156
|
Hart SR, Musci RJ, Ialongo N, Ballard ED, Wilcox HC. Demographic and clinical characteristics of consistent and inconsistent longitudinal reporters of lifetime suicide attempts in adolescence through young adulthood. Depress Anxiety 2013; 30:997-1004. [PMID: 23804209 PMCID: PMC4083681 DOI: 10.1002/da.22135] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 05/01/2013] [Accepted: 05/03/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Within the context of the recent release of the 2012 National Suicide Prevention Strategy, and as the third leading cause of death for individuals 10- to 24-years-old, suicide prevention is a national priority. A consistently reported and robust risk factor for suicide is a prior suicide attempt; however few studies have investigated the consistency of self-reported lifetime suicide attempts. The goal of this study is to describe the prevalence and characteristics of inconsistent reporting of suicide attempt in a longitudinal cohort of participants annually assessed in 12 waves of data collected from middle school (age 12) to early adulthood (age 22). METHODS Among this cohort (n = 678), we compared those who consistently, inconsistently, and never reported a suicide attempt according to demographic and clinical variables. RESULTS Almost 90% (88.5%) of our sample inconsistently reported a lifetime suicide attempt. Consistent and inconsistent reporters of lifetime suicide attempt did not differ on demographic or clinical variables with the exception of higher rates of lifetime suicidal ideation among consistent reporters (P < .001). Significant clinical differences were evident between inconsistent reporters and nonattempters. CONCLUSIONS Some level of inconsistent reporting of suicide attempt is inevitable when schools or health care systems systematically screen for suicide risk in adolescents. Inconsistent and consistent reporters of suicide attempt differ on few demographic or clinical variables; further prospective research should investigate the reasons for inconsistent reporting as well as the validity and stability of reporting in predicting future suicidal behavior.
Collapse
Affiliation(s)
- Shelley R. Hart
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Rashelle J. Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicholas Ialongo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth D. Ballard
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Holly C. Wilcox
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
157
|
Eskin M. The effects of individualistic-collectivistic value orientations on non-fatal suicidal behavior and attitudes in Turkish adolescents and young adults. Scand J Psychol 2013; 54:493-501. [DOI: 10.1111/sjop.12072] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 06/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Mehmet Eskin
- Faculty of Medicine; Department of Psychiatry; Adnan Menderes University; Turkey
| |
Collapse
|
158
|
Bühren K, Schwarte R, Fluck F, Timmesfeld N, Krei M, Egberts K, Pfeiffer E, Fleischhaker C, Wewetzer C, Herpertz-Dahlmann B. Comorbid Psychiatric Disorders in Female Adolescents with First-Onset Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2013; 22:39-44. [DOI: 10.1002/erv.2254] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 07/04/2013] [Accepted: 08/15/2013] [Indexed: 11/11/2022]
Affiliation(s)
- K Bühren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Clinics RWTH Aachen; Aachen Germany
| | - R Schwarte
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Clinics RWTH Aachen; Aachen Germany
| | - F Fluck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Clinics RWTH Aachen; Aachen Germany
| | - N Timmesfeld
- Department of Medical Statistics; University of Marburg; Marburg Germany
| | - M Krei
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Clinics RWTH Aachen; Aachen Germany
| | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University of Würzburg; Würzburg Germany
| | - E Pfeiffer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - C Fleischhaker
- Department of Child and Adolescent Psychiatry and Psychotherapy; University Clinics Freiburg; Freiburg Germany
| | - C Wewetzer
- Department of Child and Adolescent Psychiatry and Psychotherapy; Kliniken der Stadt Köln; Köln Germany
| | - B Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; University Clinics RWTH Aachen; Aachen Germany
| |
Collapse
|
159
|
Arenliu A, Kelmendi K, Haskuka M, Halimi T, Canhasi E. Drug use and reported suicide ideation and attempt among Kosovar adolescents. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2013.820803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
160
|
Fadum EA, Stanley B, Rossow I, Mork E, Törmoen AJ, Mehlum L. Use of health services following self-harm in urban versus suburban and rural areas: a national cross-sectional study. BMJ Open 2013; 3:e002570. [PMID: 23892421 PMCID: PMC3731709 DOI: 10.1136/bmjopen-2013-002570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 05/20/2013] [Accepted: 06/21/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study examines whether there is a difference between urban versus suburban and rural adolescents in their use of health services following two types of self-harm distinguished as self-harm with or without suicide intent. SETTING A nationwide cross-sectional school survey of 11 406 Norwegian adolescents aged 13-19 years in 73 Norwegian junior and senior high schools. PARTICIPANTS Adolescents who reported self-harm and provided valid responses to a follow-up question about having received subsequent help or treatment (n=959) were included in the study. Adolescents were divided into urban versus suburban and rural depending on: (1) the location of municipalities where they attended school and (2) the place of residence. Associations between urban versus suburban and rural areas and the use of health services following self-harm were assessed in those who self-harmed with and without suicide intent. PRIMARY OUTCOME MEASURE Use of health services following self-harm. RESULTS 1 in 4 adolescents reported using health services following self-harm. Adolescents reporting self-harm with suicide intent were more likely to use health services than those who self-harmed without suicide intent. Following self-harm without suicide intent, adolescents in urban areas were four times more likely to use health services than adolescents in suburban and rural areas. There was no statistically significant area difference in the use of health services following self-harm with suicide intent. CONCLUSIONS This study found a geographical variation in the use of health services following self-harm without suicide intent, but not following self-harm with suicide intent. Differences in perception of self-harm and help-seeking behaviour between areas and different accessibility to services are suggested as possible explanations. There is a need to better understand how the interplay between individual characteristics and accessibility to services influences adolescents' use of health services following self-harm. We suggest that multilevel models are a valuable approach to achieve this goal.
Collapse
Affiliation(s)
- Elin Anita Fadum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Barbara Stanley
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Ingeborg Rossow
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Norwegian Institute for Alcohol and Drug Research, Oslo, Norway
| | - Erlend Mork
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anita J Törmoen
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
161
|
Cheung YTD, Wong PWC, Lee AM, Lam TH, Fan YSS, Yip PSF. Non-suicidal self-injury and suicidal behavior: prevalence, co-occurrence, and correlates of suicide among adolescents in Hong Kong. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1133-44. [PMID: 23262815 DOI: 10.1007/s00127-012-0640-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 12/05/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite increasing concern over the prevalence of non-suicidal self-injury (NSSI) among adolescents, there is debate about its classification as a stand-alone psychiatric diagnosis. This study investigated the patterns, co-occurrence, and correlates of NSSI and other suicidal behaviors among a representative community sample of in-school adolescents. METHODS A cross-sectional survey of 2,317 adolescents was conducted. Participants were asked to self-report NSSI, suicidal ideation, suicide attempt, and psychosocial conditions over the past 12 months. Logistic regression and cumulative logit modeling analyses were conducted to investigate the different and similar correlates among these self-harm behaviors. RESULTS The age-standardized prevalence rates of NSSI among male and female adolescents were estimated to be 13.4 and 19.7 %, respectively, compared with 11.1 and 10.1 % for male and female suicide attempt. Only a small proportion engaged in NSSI exclusively in the past year. NSSI by burning or reckless and risky behaviors, frequent drinking, and sexual experience were associated with increasing severity level of suicidal behaviors among individuals with NSSI. CONCLUSIONS NSSI is prevalent among in-school adolescents in Hong Kong. However, it co-occurs with suicidal ideation and suicide attempt. High lethality of NSSI, frequent drinking habit, and lifetime sexual experience are suggested to be indicators for screening potential suicide attempters among those having NSSI.
Collapse
Affiliation(s)
- Yee Tak Derek Cheung
- School of Public Health, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | | | | | | | | | | |
Collapse
|
162
|
Phillips R, Spears MR, Montgomery AA, Millings A, Sayal K, Stallard P. Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis. BMC Public Health 2013; 13:604. [PMID: 23800153 PMCID: PMC3733623 DOI: 10.1186/1471-2458-13-604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 06/18/2013] [Indexed: 12/01/2022] Open
Abstract
Background Self-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings. Methods Data were collected as part of a clinical trial from young people in school years 8–11 (aged 12–16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children’s Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months. Results Following a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77). Conclusions A brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to help identify adolescents who are at risk in community settings. Further research should assess the psychometric properties of the items identified and test this approach in more diverse community contexts.
Collapse
Affiliation(s)
- Rhiannon Phillips
- Department for Health, University of Bath, 22-23 Eastwood, Claverton Down, Bath BA2 7AY, UK.
| | | | | | | | | | | |
Collapse
|
163
|
Plener PL, Fegert JM, Kölch MG. Psychopharmakologische Behandlung von Depressionen im Kindes- und Jugendalter. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2012; 40:365-71. [DOI: 10.1024/1422-4917/a000196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Die psychopharmakologische Behandlung kann – je nach Schweregrad- eine wichtige Option in der Therapie depressiver Erkrankungen bei Kindern und Jugendlichen darstellen. Diese Überblicksarbeit gibt klinische Behandlungsempfehlungen mit einem Fokus auf den Umgang mit Suizidalität und therapieresistenten Patienten. Die Studienlage zur medikamentösen Therapie der depressiven Erkrankung im Kindes- und Jugendalter hat sich seit den Warnungen der amerikanischen Zulassungsbehörde zum Auftreten von Suizidalität unter Therapie mit Selektiven Serotonin Wiederaufnahmehemmern (SSRIs) deutlich verbessert. In der Versorgung von depressiven Kindern und Jugendlichen ist in den letzten Jahren in Deutschland ein Trend hin zu einer evidenzbasierten psychopharmakologischen Therapie zu erkennen.
Collapse
Affiliation(s)
- Paul L. Plener
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Ulm
| | - Jörg M. Fegert
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Ulm
| | - Michael G. Kölch
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Ulm
- Kliniken für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Vivantes Netzwerk für Gesundheit GmbH, Berlin
| |
Collapse
|
164
|
Kokkevi A, Richardson C, Olszewski D, Matias J, Monshouwer K, Bjarnason T. Multiple substance use and self-reported suicide attempts by adolescents in 16 European countries. Eur Child Adolesc Psychiatry 2012; 21:443-50. [PMID: 22535305 DOI: 10.1007/s00787-012-0276-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 04/04/2012] [Indexed: 11/29/2022]
Abstract
Substance use and suicide attempts are high-risk behaviors in adolescents, with serious impacts on health and well-being. Although multiple substance use among young people has become a common phenomenon, studies of its association with suicide attempts are scarce. The present study examines the association between multiple substance use and self-reported suicide attempts in a large multinational sample of adolescent students in Europe. Data on multiple substance use (tobacco, alcohol, tranquillizers/sedatives, cannabis, other illegal drugs) and self-reported suicide attempts were drawn from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). The ESPAD survey follows a standardized methodology in all participating countries. The present study is based on 45,086 16-year-old adolescents from 16 countries that had used the optional "psychosocial module" of the questionnaire, thereby including the question on suicide attempts. Logistic regression analyses were performed to examine the associations of any self-reported suicide attempt (dependent variable) with substance use controlling for country and gender. The strongest association with self-reported suicide attempts was for any lifetime tranquillizer or sedative use (odds ratio 3.34, 95 % confidence interval 3.00-3.71) followed by any lifetime use of illegal drugs other than cannabis (2.41, 2.14-2.70), 30-day regular tobacco use (2.02, 1.84-2.21), 30-day frequent alcohol use (1.47, 1.32-1.63) and any 30-day cannabis use (1.37, 1.18-1.58). The odds ratio of reporting a suicide attempt approximately doubled for every additional substance used. These findings on the association between multiple substance use, including legal drugs (tranquillizers or sedatives and tobacco), and the life-threatening behavior of suicide attempts provide important cues for shaping prevention policies.
Collapse
Affiliation(s)
- Anna Kokkevi
- Department of Psychiatry, Medical School, Athens University, Greece.
| | | | | | | | | | | |
Collapse
|
165
|
Kidger J, Heron J, Lewis G, Evans J, Gunnell D. Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England. BMC Psychiatry 2012; 12:69. [PMID: 22737989 PMCID: PMC3439325 DOI: 10.1186/1471-244x-12-69] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 06/12/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored. METHOD Cross-sectional analysis of self-reported questionnaire data collected from members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England. Respondents (n = 4810) were aged 16-17 years old and have been followed up since birth. RESULTS Altogether 905 (18.8%) respondents had ever self-harmed. The prevalence of lifetime self-harm was higher in females (25.6%) than males (9.1%). The most commonly used method was self-cutting: this was used alone or in combination in 73.5% of episodes, compared to 10.0% who took overdoses alone or in combination with other methods. Of those who reported self-harm, 25.3% wanted to die during the most recent episode. Concurrent depression was associated with a greatly increased risk of self-harm (OR 5.43). Only 12.4% of participants sought medical help following their most recent episode of self-harm, although this figure was higher (30.1%) where self-harm was carried out with desire to die. Of the whole sample, 15.8% had ever thought of killing themselves, and 4.3% had ever made plans to kill themselves. Compared to those who had never self-harmed, those who had self-harmed but not wanted to die during the most recent episode were at increased risk of ever having had suicidal thoughts (37.6% compared to 7.8% χ2 =102.3, p < 0.001) and ever making suicidal plans (8.7% compared to 0.7%, χ2 =166.9, p < 0.001). As the frequency of self-harm increased, so did the risk of suicidal thoughts and plans. CONCLUSIONS Self-harm and suicidal thoughts are common among 16/17 year olds. Although the majority of self-harm behaviour is not accompanied by a desire to die, all self-harm regardless of motivation is associated with increased risk of suicidal thoughts and plans, particularly when it is carried out repeatedly.
Collapse
Affiliation(s)
- Judi Kidger
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - Glyn Lewis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - Jonathan Evans
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
166
|
Social aspects of suicidal behavior and prevention in early life: a review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:985-94. [PMID: 22690178 PMCID: PMC3367292 DOI: 10.3390/ijerph9030985] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 11/17/2022]
Abstract
PURPOSE The present review summarizes the updated literature on the social aspects of suicidal behavior and prevention in adolescents. RECENT FINDINGS The predictive role of psychiatric disorders and past history are well recognized in adolescent suicide, but the role of social and cultural factors is less clear. Studies have focused on the importance of ethnicity, gender, family characteristics, and socioeconomic status. More recently, attention has been addressed to broader social risk factors, such as bullying in adolescents, suicide contagion, sexual orientation, and the popular media. Further empirical evidence is needed to advance our understanding of suicidal youth, develop better assessment tools, and formulate effective prevention and treatment programs. SUMMARY Suicidal behavior remains an important clinical problem and major cause of death in youth. Social factors may be at least as important as genetics. Advancing our understanding of underlying cultural and sociological issues in youth suicide will help clinicians achieve more efficient prediction, prevention and treatment.
Collapse
|
167
|
Durkee T, Hadlaczky G, Westerlund M, Carli V. Internet pathways in suicidality: a review of the evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:3938-52. [PMID: 22073021 PMCID: PMC3210590 DOI: 10.3390/ijerph8103938] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 10/04/2011] [Accepted: 10/05/2011] [Indexed: 01/28/2023]
Abstract
The general aim of this study was to review the scientific literature concerning the Internet and suicidality and to examine the different pathways by which suicidal risks and prevention efforts are facilitated through the Internet. An online literature search was conducted using the MEDLINE and Google Scholar databases. The main themes that were investigated included pathological Internet use and suicidality, pro-suicide websites, suicide pacts on the Internet, and suicide prevention via the Internet. Articles were screened based on the titles and abstracts reporting on the themes of interest. Thereafter, articles were selected based on scientific relevance of the study, and included for full text assessment. The results illustrated that specific Internet pathways increased the risk for suicidal behaviours, particularly in adolescents and young people. Several studies found significant correlations between pathological Internet use and suicidal ideation and non-suicidal self-injury. Pro-suicide websites and online suicide pacts were observed as high-risk factors for facilitating suicidal behaviours, particularly among isolated and susceptible individuals. Conversely, the evidence also showed that the Internet could be an effective tool for suicide prevention, especially for socially-isolated and vulnerable individuals, who might otherwise be unreachable. It is this paradox that accentuates the need for further research in this field.
Collapse
Affiliation(s)
- Tony Durkee
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
| | - Gergo Hadlaczky
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
| | - Michael Westerlund
- Department of Journalism, Media and Communication (JMK), Stockholm University, Stockholm SE-115 93, Sweden; E-Mail:
| | - Vladimir Carli
- The National Swedish Prevention of Suicide and Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm SE-171 77, Sweden; E-Mails: (G.H.); (V.C.)
| |
Collapse
|