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Mirkovic B, Delvenne V, Robin M, Pham-Scottez A, Corcos M, Speranza M. Borderline personality disorder and adolescent suicide attempt: the mediating role of emotional dysregulation. BMC Psychiatry 2021; 21:393. [PMID: 34372810 PMCID: PMC8351432 DOI: 10.1186/s12888-021-03377-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation. METHODS This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders. RESULTS In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents. CONCLUSIONS These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.
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Affiliation(s)
- Bojan Mirkovic
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "DevPsy", 94807, Villejuif, France. .,Pôle de psychiatrie de l'enfant et de l'adolescent, Nouvel Hôpital de Navarre, Université de Normandie, Nouvel Hôpital de Navarre, route de Conches, 27000, Évreux, France.
| | - Véronique Delvenne
- grid.412209.c0000 0004 0578 1002Service de Pédopsychiatrie, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Marion Robin
- grid.418120.e0000 0001 0626 5681Département de Psychiatrie de l’Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Paris, France
| | - Alexandra Pham-Scottez
- grid.414435.30000 0001 2200 9055GHT Paris Psychiatrie et Neurosciences, Centre Hospitalier Sainte Anne, Paris, France
| | - Maurice Corcos
- grid.418120.e0000 0001 0626 5681Département de Psychiatrie de l’Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Paris, France
| | - Mario Speranza
- grid.463845.80000 0004 0638 6872Université Paris-Saclay, UVSQ, Inserm U1018, CESP, “DevPsy”, 94807 Villejuif, France ,grid.418080.50000 0001 2177 7052Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Centre Hospitalier de Versailles, Versailles, France
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202
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Rioux C, Huet AS, Castellanos-Ryan N, Fortier L, Le Blanc M, Hamaoui S, Geoffroy MC, Renaud J, Séguin JR. Substance use disorders and suicidality in youth: A systematic review and meta-analysis with a focus on the direction of the association. PLoS One 2021; 16:e0255799. [PMID: 34358273 PMCID: PMC8345848 DOI: 10.1371/journal.pone.0255799] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Reviews and meta-analyses suggest that substance use and suicidality (i.e., suicidal ideations and attempts) are associated in youth, but the direction of this association remains unclear. Theoretically, the secondary psychiatric disorder hypothesis (SPDH) posits that substance use leads to suicidality, while the secondary substance use disorder hypothesis (SSUDH) posits that suicidality leads to substance use. To clarify these associations, this meta-analysis systematically reviewed studies that examined the prospective associations between SUDs and suicidality in youth (age 25 and younger) and compared results according to the direction of the association. METHODS Web of Science, Embase, PsycINFO, PubMed, Medline and ProQuest Dissertations & Theses Global were searched from inception to March 8, 2020, and 55 effect sizes from 23 samples were included and analyzed using a three-level meta-analysis. RESULTS SUDs significantly predicted subsequent suicidality (OR = 2.16, 95%CI 1.57-2.97), suicidality significantly predicted subsequent SUDs (OR = 2.16, 95%CI 1.53-3.04), and these effect sizes did not differ (p = 0.49). CONCLUSIONS Considering that 65% of reviewed studies only examined the SPDH, this review highlights that more attention should be given to the SSUDH, and that studies should examine bidirectional associations between SUDs and suicidality across time. Clinically, because SUDs and suicidality were found to influence each other, results suggest that mental health and SUDs should ideally be detected and treated early, and that co-occurring disorders should be assessed and treated concomitantly.
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Affiliation(s)
- Charlie Rioux
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas, United States of America
| | - Anne-Sophie Huet
- Department of Child and Adolescent Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Natalie Castellanos-Ryan
- School of Psychoeducation, Université de Montréal, Montreal, Québec, Canada
- CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Laurianne Fortier
- School of Psychoeducation, Université de Montréal, Montreal, Québec, Canada
| | - Myriam Le Blanc
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Québec, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montreal, Québec, Canada
| | - Stéphanie Hamaoui
- Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Marie-Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Johanne Renaud
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montreal, Québec, Canada
| | - Jean R. Séguin
- CHU Ste-Justine Research Centre, Montreal, Québec, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Québec, Canada
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203
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Cameron CM, Nieto S, Bosler L, Wong M, Bishop I, Mooney L, Cahill CM. Mechanisms Underlying the Anti-Suicidal Treatment Potential of Buprenorphine. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2021; 1. [PMID: 35265942 PMCID: PMC8903193 DOI: 10.3389/adar.2021.10009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Death by suicide is a global epidemic with over 800 K suicidal deaths worlwide in 2012. Suicide is the 10th leading cause of death among Americans and more than 44 K people died by suicide in 2019 in the United States. Patients with chronic pain, including, but not limited to, those with substance use disorders, are particularly vulnerable. Chronic pain patients have twice the risk of death by suicide compared to those without pain, and 50% of chronic pain patients report that they have considered suicide at some point due to their pain. The kappa opioid system is implicated in negative mood states including dysphoria, depression, and anxiety, and recent evidence shows that chronic pain increases the function of this system in limbic brain regions important for affect and motivation. Additionally, dynorphin, the endogenous ligand that activates the kappa opioid receptor is increased in the caudate putamen of human suicide victims. A potential treatment for reducing suicidal ideation and suicidal attempts is buprenorphine. Buprenorphine, a partial mu opioid agonist with kappa opioid antagonist properties, reduced suicidal ideation in chronic pain patients with and without an opioid use disorder. This review will highlight the clinical and preclinical evidence to support the use of buprenorphine in mitigating pain-induced negative affective states and suicidal thoughts, where these effects are at least partially mediated via its kappa antagonist properties.
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Affiliation(s)
- Courtney M. Cameron
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Steven Nieto
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lucienne Bosler
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Megan Wong
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Isabel Bishop
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Larissa Mooney
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Catherine M. Cahill
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Shirley and Stefan Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Correspondence: Catherine M. Cahill,
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204
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Key R, Underwood A, Farnham F, Marzano L, Hawton K. Suicidal behavior in individuals accused or convicted of child sex abuse or indecent image offenses: Systematic review of prevalence and risk factors. Suicide Life Threat Behav 2021; 51:715-728. [PMID: 33811669 DOI: 10.1111/sltb.12749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 10/29/2020] [Accepted: 12/09/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE An emerging body of research indicates that child sex abuse (CSA) offenders are at high risk of suicide when their offenses come to light and that those accused of accessing indecent images of children (IIOC) are at particular risk. METHODS We conducted a systematic review and narrative synthesis on suicide rates and risk factors in this population of offenders. A keyword search of bibliographic databases (PsycINFO, Ovid, MEDLINE, Embase, PILOTS, SCIE, the Cochrane Central Register of Controlled Trials [CENTRAL] and CINAHL) was conducted. RESULTS Eighteen articles were included in the review, with eleven studies meeting criteria for quality assessment. The risk of suicide in perpetrators of CSA and IIOC might be over 100 times that of the general population, although estimates vary widely between studies. Several complex, interlinking factors were identified as associated with risk, including shame, unique demographic characteristics of the offenders, absence of prior criminal contact, and the impact of a criminal investigation. CONCLUSIONS The review identified factors that may have practical, clinical, and operational implications in the prevention of suicide in CSA and IIOC perpetrators. Exploring the impact of the investigation itself on suicide risk, including potential operational strategies and clinical input to reduce risk, should be a priority.
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Affiliation(s)
- Rebecca Key
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Alan Underwood
- Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Frank Farnham
- Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK.,UCL Department of Security and Crime Science, London, UK
| | | | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
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205
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Cornelius SL, Berry T, Goodrich AJ, Shiner B, Riblet NB. The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157809. [PMID: 34360101 PMCID: PMC8345465 DOI: 10.3390/ijerph18157809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/07/2022]
Abstract
Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.
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Affiliation(s)
- Sarah L. Cornelius
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Correspondence: ; Tel.: +1-(802)-295-9363
| | - Tara Berry
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
| | - Amanda J. Goodrich
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA;
| | - Brian Shiner
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Natalie B. Riblet
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
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206
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Suicide and Associations with Air Pollution and Ambient Temperature: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147699. [PMID: 34300149 PMCID: PMC8303705 DOI: 10.3390/ijerph18147699] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022]
Abstract
Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic literature review and meta-analysis of suicide risks associated with short-term exposure to ambient temperature and air pollution. Pubmed, Scopus, and Web of Science were searched for English-language publications using relevant keywords. Observational studies assessing risks of daily suicide and suicide attempts associated with temperature, particulate matter with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 mm (PM2.5), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were included. Data extraction was independently performed in duplicate. Random-effect meta-analysis was applied to pool risk ratios (RRs) for increases in daily suicide per interquartile range (IQR) increase in exposure. Meta-regression analysis was applied to examine effect modification by income level based on gross national income (GNI) per capita, national suicide rates, and average level of exposure factors. In total 2274 articles were screened, with 18 studies meeting inclusion criteria for air pollution and 32 studies for temperature. RRs of suicide per 7.1 °C temperature was 1.09 (95% CI: 1.06, 1.13). RRs of suicide per IQR increase in PM2.5, PM10, and NO2 were 1.02 (95% CI: 1.00, 1.05), 1.01 (95% CI: 1.00, 1.03), and 1.03 (95% CI: 1.00, 1.07). O3, SO2, and CO were not associated with suicide. RR of suicide was significantly higher in higher-income than lower-income countries (1.09, 95% CI: 1.07, 1.11 and 1.20, 95% CI: 1.14, 1.26 per 7.1 °C increased temperature, respectively). Suicide risks associated with air pollution did not significantly differ by income level, national suicide rates, or average exposure levels. Research gaps were found for interactions between air pollution and temperature on suicide risks.
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207
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del Carpio L, Paul S, Paterson A, Rasmussen S. A systematic review of controlled studies of suicidal and self-harming behaviours in adolescents following bereavement by suicide. PLoS One 2021; 16:e0254203. [PMID: 34242305 PMCID: PMC8270178 DOI: 10.1371/journal.pone.0254203] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/23/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Research suggests that being exposed to the suicide of others increases risk of subsequent suicidal or self-harming thoughts or behaviours. What is less clear is whether this applies to adolescents, and if the risk exceeds that following other causes of death, which has implications on suicide prevention approaches. This study aimed to systematically review the evidence on adolescent bereavement experiences by different causes to address this gap. METHODS A comprehensive literature search using four databases (MEDLINE, PsycInfo, Web of Science, and Embase) identified 21 studies which measured suicidal or self-harm outcomes among bereaved adolescents aged between 12 to 18 years old. The literature was screened, data was extracted using pre-piloted forms, and risk of bias was assessed using versions of the Newcastle-Ottawa Scale; a proportion of papers were double extracted and assessed for bias. The review has been registered with PROSPERO (CRD42016051125). RESULTS A narrative synthesis of the literature demonstrated divergent findings depending on the outcome being measured. Suicide bereavement appears to be strongly associated with suicide mortality among parentally bereaved youth, while self-harm or non-fatal suicide attempts (either presenting to hospital or self-reported) showed mixed evidence. Suicidal ideation was not uniquely associated with suicide bereavement. An exploration of circumstances surrounding the death, characteristics of the person who died, and characteristics of the young person across each outcome measure suggested that earlier experiences of loss, shorter timeframes following the death, and maternal death are associated with particularly elevated risk of suicidal outcomes. CONCLUSIONS Findings suggest that suicide loss is associated with subsequent suicide, and may be associated with non-fatal self-harm. A detailed account of the risk and protective factors surrounding suicide bereavement among young people is crucial to understand the pathways through which suicidal behaviours develop. Researchers, policy makers and practitioners with an interest in suicide prevention will benefit from clarity around the needs of young bereaved individuals.
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Affiliation(s)
- Laura del Carpio
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Sally Paul
- School of Social Work and Social Policy, University of Strathclyde, Glasgow, United Kingdom
| | - Abigail Paterson
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
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208
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Theta burst stimulation in adolescent depression: An open-label evaluation of safety, tolerability, and efficacy. Brain Stimul 2021; 14:1051-1053. [PMID: 34229115 DOI: 10.1016/j.brs.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
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209
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Del-Monte J, Graziani P. Anticipatory, Relief-Oriented and Permissive Beliefs in Patients with Suicidal Behaviors: An Exploratory Case-Control Study. Arch Suicide Res 2021; 25:629-640. [PMID: 32202480 DOI: 10.1080/13811118.2020.1738969] [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: 10/24/2022]
Abstract
OBJECTIVE The objective is to propose a specific understanding of decision-making in suicidal behavior by using a psychometric instrument, namely the Suicidal Ambivalence Scale (SAS). The SAS, initially used in addictive disorders, allows to distinguish 3 types of thoughts: first anticipatory beliefs [A] (positive expectations regarding behavior); second relief-oriented beliefs [R] (aim to reduce the feeling of suffering) and finally, permissive beliefs [P] (authorize the passage to the act). In addictions disorders, these thoughts favor craving and the act of consumption. We make the hypothesis that the processes of suicidal thoughts function similarly to thought processes in addiction and that all thoughts [A, S and P] are significantly more present in suicidal patients. METHODS 120 suicidal crisis patients and 161 healthy controls were compared on clinical dimensions (levels of depression, hopelessness). Anticipatory, relief-oriented and permissive beliefs were evaluated with the suicidal ambivalence scale. RESULTS Patients have statistically more of beliefs in favor of suicidal behavior to compared healthy controls (t = 2.375, p = 0.019, d = 0.57), more particularly, anticipatory and permissive beliefs. Conversely, patients have statistically less of protective thoughts against the suicidal behavior to compared healthy controls (t = 2.195, p = 0.03, d = 0.499). CONCLUSION This study showed the role of anticipatory, relief-oriented and permissive beliefs in the suicidal crisis and the need to create a simple and easy to use clinical tool for more accurate assessments of beliefs in patients with the suicidal crisis.
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210
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Zalsman G, Levy Y, Sommerfeld E, Segal A, Assa D, Ben-Dayan L, Valevski A, Mann JJ. Suicide-related calls to a national crisis chat hotline service during the COVID-19 pandemic and lockdown. J Psychiatr Res 2021; 139:193-196. [PMID: 34087516 PMCID: PMC8769684 DOI: 10.1016/j.jpsychires.2021.05.060] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 05/08/2021] [Accepted: 05/21/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND A COVID-19 pandemic-related rise in suicide rates has been predicted due to social isolation, fear, uncertainty, economic turndown and grief. Detecting an increase in suicide rates is difficult in the absence of real-time data. Alternative data sources for such trends in psychopathology and suicidal behavior must be sought. METHODS Data from a national chat-based crisis hotline for the first half of 2019 (pre-COVID-19), were compared to data from the first half of 2020 (during COVID-19). Chat sessions were classified by content and demographics and the data compared between the two time periods. OUTCOME Total chats (n = 6756) were 48% higher during COVID-19 (p < .05). Suicide-related chat (SRC) number was also higher, although the proportion relative to all chats was slightly lower during COVID-19, compared to pre-COVID-19 (p < .05). SRCs increased during the COVID-19 lockdown. The number of severe SRCs resulting in urgent police intervention, increased during the lockdown (April-May 2020) compared with the same period in 2019 (p = .04). Issues of anxiety were higher in 2020 (19.4%) vs. 2019 (16.5%) (p < .00001) while issues of depression were lower (22.4% vs 33%, respectively) (p < .00001). The overall use of chats among adults aged >50 yrs increased during COVID-19 and likewise, the rate of SRCs in this age-group increased 30-fold in this period when compared to pre-COVID-19 (p < .00001). SRCs included more women than men (p < .0001) in both pre-COVID-19 and during the COVID-19 period, when the proportion of women increased from 62% in 2019 to 73% during COVID-19 (p < .0001). INTERPRETATION The rise in total chats, SRCs and SRCs resulting in police action, commenced during lockdown and was ameliorated by end of the lockdown, indicating that distress created by the lockdown was more impactful than mourning deaths of loved ones, fear and uncertainty, because all these factors persisted beyond the end of the lockdown. Older populations were probably more distressed due to greater risk and less adaptability to isolation, social media and staying home. More calls by women may reflect women's better help-seeking capacity. The increase in SRCs indicates the potential for more suicides and the need for bolstering mental health services and reach-out to older people during pandemic lock-downs.
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Affiliation(s)
- Gil Zalsman
- Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA.
| | | | | | - Avi Segal
- Department of Software and Information Systems Engineering, Ben-Gurion University of the Negev, Israel
| | | | | | - Avi Valevski
- Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA
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211
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Li X, Ren Y, Zhang X, Zhou J, Su B, Liu S, Cai H, Liu J, You J. Testing the Integrated Motivational-Volitional Model of Suicidal Behavior in Chinese Adolescents. Arch Suicide Res 2021; 25:373-389. [PMID: 32013796 DOI: 10.1080/13811118.2019.1690607] [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: 10/25/2022]
Abstract
The integrated motivational-volitional model of suicidal behavior (IMV; O'Connor & Kirtley, 2018) integrates some key factors of suicidal behavior (e.g., defeat and entrapment) to explain the development of suicidal ideation and suicidal attempts. This study aimed to empirically test this model in a sample of Chinese adolescents. A number of 1,239 Chinese adolescents (679 girls; Mage = 14.07, SD = 1.54) completed self-report questionnaires. Results showed that defeat was associated with entrapment, which, in turn, was related to suicidal ideation and suicidal attempts. In addition, the relationship between entrapment and suicidal ideation was significant at high levels of thwarted belongingness and perceived burdensomeness, and low levels of resilience. These findings support the application of the IMV model in Chinese adolescents, and might help mental health organizations and educational agencies formulate effective suicidal prevention programs geared toward Chinese adolescents.
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212
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Karnecki K, Steiner J, Guest PC, Krzyżanowska M, Mańkowski D, Gos T, Kaliszan M. Epidemiology of suicide in the Tricity metropolitan area in northern Poland 1980–2009: Evidence of influence by political and socioeconomic changes. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2021. [DOI: 10.1016/j.fsir.2021.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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213
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Sewall CJ, Girard JM, Merranko J, Hafeman D, Goldstein BI, Strober M, Hower H, Weinstock LM, Yen S, Ryan ND, Keller MB, Liao F, Diler RS, Gill MK, Axelson D, Birmaher B, Goldstein TR. A Bayesian multilevel analysis of the longitudinal associations between relationship quality and suicidal ideation and attempts among youth with bipolar disorder. J Child Psychol Psychiatry 2021; 62:905-915. [PMID: 33107600 PMCID: PMC8628509 DOI: 10.1111/jcpp.13343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/20/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Youth with bipolar disorder (BD) are at high risk for suicidal thoughts and behaviors and frequently experience interpersonal impairment, which is a risk factor for suicide. Yet, no study to date has examined the longitudinal associations between relationship quality in family/peer domains and suicidal thoughts and behaviors among youth with BD. Thus, we investigated how between-person differences - reflecting the average relationship quality across time - and within-person changes, reflecting recent fluctuations in relationship quality, act as distal and/or proximal risk factors for suicidal ideation (SI) and suicide attempts. METHODS We used longitudinal data from the Course and Outcome of Bipolar Youth Study (N = 413). Relationship quality variables were decomposed into stable (i.e., average) and varying (i.e., recent) components and entered, along with major clinical covariates, into separate Bayesian multilevel models predicting SI and suicide attempt. We also examined how the relationship quality effects interacted with age and sex. RESULTS Poorer average relationship quality with parents (β = -.33, 95% Bayesian highest density interval (HDI) [-0.54, -0.11]) or friends (β = -.33, 95% HDI [-0.55, -0.11]) was longitudinally associated with increased risk of SI but not suicide attempt. Worsening recent relationship quality with parents (β = -.10, 95% HDI [-0.19, -0.03]) and, to a lesser extent, friends (β = -.06, 95% HDI [-0.15, 0.03]) was longitudinally associated with increased risk of SI, but only worsening recent relationship quality with parents was also associated with increased risk of suicide attempt (β = -.15, 95% HDI [-0.31, 0.01]). The effects of certain relationship quality variables were moderated by gender but not age. CONCLUSIONS Among youth with BD, having poorer average relationship quality with peers and/or parents represents a distal risk factor for SI but not suicide attempts. Additionally, worsening recent relationship quality with parents may be a time-sensitive indicator of increased risk for SI or suicide attempt.
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Affiliation(s)
| | | | - John Merranko
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Benjamin I. Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University,Department of Health Services, Policy, and Practice, Brown University School of Public Health
| | - Lauren M. Weinstock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Neal D. Ryan
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Martin B. Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
| | - Fangzi Liao
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Rasim S. Diler
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
| | - Tina R. Goldstein
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine
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Morthorst BR, Mehlum L, Pàlsson SP, Mühlmann C, Hammerlin Y, Madsen T, Nordentoft M, Erlangsen A. Suicide Rates in Nordic Prisons 2000-2016. Arch Suicide Res 2021; 25:704-714. [PMID: 32252604 DOI: 10.1080/13811118.2020.1746943] [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] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare suicide rates of people in prison and the general population in the Nordic countries. METHODS Data on deaths by suicide and person-years for people in prison and the general population were obtained for the Nordic countries during 2000-2016. Age-standardized rate ratios were calculated. RESULTS The suicide rate in the Nordic countries overall was 110.1 (95% CI = 98.1, 122.2) per 100,000 person-years for people in prison. A significant decline was noted for the suicide rate of people in prison between 2000 and 2016 (p < 0.0001). The age-standardized mortality ratio was 7.4 (95% CI = 5.9-8.2) for males and 17.8 (95% CI = 7.3-33.2) for females in Denmark, Iceland, and Norway. CONCLUSION Despite a decreasing trend over time, excess suicide mortality was noted for people in prison.
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215
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Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health 2021; 25:1262-1272. [PMID: 32602736 DOI: 10.1080/13607863.2020.1786798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- Department of Health Management, Heze Medical College, Heze, Shandong, China
| | - Jie Zhang
- China Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA.,School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
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216
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Habu H, Takao S, Fujimoto R, Naito H, Nakao A, Yorifuji T. Emergency dispatches for suicide attempts during the COVID-19 outbreak in Okayama, Japan: A descriptive epidemiological study. J Epidemiol 2021; 31:511-517. [PMID: 34176855 PMCID: PMC8328858 DOI: 10.2188/jea.je20210066] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. Methods This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019, and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. Results The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25–49 years. Among women aged 25–49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. Conclusions The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25–49 years. This increase may be partly explained by hardships, such as economic losses or reduced social ties, during the COVID-19 outbreak.
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Affiliation(s)
- Hiroshi Habu
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Soshi Takao
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Ryohei Fujimoto
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Cardiovascular Medicine, Okayama University Hospital
| | - Hiromichi Naito
- Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Atsunori Nakao
- Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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217
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Green space and suicide mortality in Japan: An ecological study. Soc Sci Med 2021; 282:114137. [PMID: 34175573 DOI: 10.1016/j.socscimed.2021.114137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
Although numerous studies have investigated the effect of green space on mental health, as yet, little is known about the association between green space and suicide. To address this deficit, we conducted the first Japan-wide study of the relationship between green space and suicide mortality. Results from spatial analyses of municipality-level panel data for the 1975-2014 period that included 886,440 suicide deaths with a fixed-effect estimator showed that green space was associated with suicide mortality, and that this relationship was conditioned by the form of greenness, level of urbanity and demographic characteristics. In densely populated cities, park density (parks per 1000 of the population) was associated with reduced suicide mortality among females aged 18 and above and among males aged 18 to 39 and aged 65 and above. In small- and medium-sized cities, park coverage (% by area) was linked to fewer suicide deaths among middle-aged and older females (aged 40 and above). In contrast, in non-cities (rural areas), parks were not associated with suicide mortality whereas woodland coverage (% by area) was linked to reduced suicide deaths among middle-aged and older males (aged 40 and above). Our findings suggest that urban green space and rural forest coverage may have a protective effect against self-harming behavior. Future suicide prevention efforts should consider an increased greening of the residential environment in terms of both availability and accessibility, especially with better designs that accommodate population needs and local conditions.
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218
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Kato T. Moderation Effects of Coping Flexibility on the Association Between Depressive Symptoms and Suicidal Risk. CRISIS 2021; 43:398-403. [PMID: 34128687 DOI: 10.1027/0227-5910/a000800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: This study focused on poor coping flexibility, which involves the perseveration of a failed coping strategy, as a moderator of the association between depression and suicidal risk; no study has previously examined the association between coping flexibility and suicidal risk. Aims: This study examined whether individuals with lower coping flexibility would have a stronger suicidal risk when experiencing depression above a certain level. Method: Participants, who were 682 college students, answered questionnaires regarding coping flexibility, depressive symptoms, and suicidal risk. Results: Hierarchical multiple regression analyses showed that in individuals with greater depressive symptoms, lower coping flexibility was associated with higher suicidal risk, but this was not the case in individuals without depressive symptoms. Our hypothesis was supported. Limitations: Our findings cannot indicate the causal direction of the association between coping flexibility and depressive symptoms and suicidal risk. Conclusion: Our findings may be useful in understanding the association between depression and suicidal risk through coping flexibility and contribute to reductions in suicidal risk, as coping flexibility can be improved through training.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Tokyo University, Japan
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219
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Gill H, Perez CD, Gill B, El-Halabi S, Lee Y, Lipsitz O, Park C, Mansur RB, Rodrigues NB, McIntyre RS, Rosenblat JD. The Prevalence of Suicidal Behaviour in Fibromyalgia Patients. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110078. [PMID: 32853715 DOI: 10.1016/j.pnpbp.2020.110078] [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: 05/31/2020] [Revised: 08/13/2020] [Accepted: 08/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) is a condition associated with chronic pain in muscles and soft tissues. Extant literature has demonstrated an association between FM, mood symptoms and suicidal behaviour. This systematic review aims to synthesize available literature assessing the prevalence of suicidality in FM populations and qualitatively review the included articles. METHODS PsycINFO, Google Scholar and PubMed databases were systematically searched for studies published from database inception to 15 February 2020. Studies were included that assessed FM as a primary or co-primary disease condition, as well as an assessment of suicidal behaviour (suicidal ideations (SI), suicide attempts (SA) and death by suicide (SC)). The quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS 699 unique articles were reviewed for eligibility. Data were derived from nine studies (cross-sectional: k = 5; retrospective cohort: k = 4) that assessed suicidal behaviour in FM participants (SI: k = 5, SC: k = 3, SA: k = 3). Four studies assessing SI found elevated rates of SI among FM participants. Three studies found elevated risk for SC and three studies found increased SA in FM participants relative to the general population. In two studies, this association was no longer significant after adjusting for depression and other psychiatric comorbidities. CONCLUSION Preliminary findings suggest that FM is associated with significantly higher risks for SI, SA and SC compared to the general population. There may be unique risk factors underlying suicidal behaviour in FM patients and the interaction between FM and other known risk factors (i.e., mental illness) require further investigation.
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Affiliation(s)
- Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
| | - Carlos D Perez
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Barjot Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Sabine El-Halabi
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Caroline Park
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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220
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Cortisol response to acute psychosocial stress in ADHD compared to conduct disorder and major depressive disorder: A systematic review. Neurosci Biobehav Rev 2021; 127:899-916. [PMID: 34089765 DOI: 10.1016/j.neubiorev.2021.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/26/2021] [Accepted: 06/01/2021] [Indexed: 01/15/2023]
Abstract
BERNHARD, A., J. S. Mayer, N. Fann, and C. M. Freitag. Cortisol response to acute psychosocial stress in ADHD compared to Conduct Disorder and Major Depressive Disorder: A systematic review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2020. - Heterogeneous alterations of the cortisol stress response in Attention-deficit/hyperactivity Disorder (ADHD) were recently reported by a systematic literature review. To investigate the moderating effect of frequent psychiatric comorbidities, we systematically searched for studies on cortisol stress response to psychosocial stress in ADHD compared to Conduct Disorder (CD) and Major Depressive Disorder (MDD) following PRISMA guidelines. EBSCOhost and PubMed databases were searched in July 2020, employing relevant keywords. Nineteen studies met inclusion criteria. While blunted cortisol stress response was consistently reported in individuals with CD and/or Oppositional Defiant Disorder (ODD), alterations of cortisol stress response were less pronounced in ADHD. Consistently blunted cortisol stress response in ADHD was only found in children with comorbid CD/ODD. Results on cortisol stress response in children and adolescents with MDD were mixed, and no indication for influence of comorbid MDD on cortisol stress response in ADHD was found. Taken together, altered cortisol stress response in ADHD is driven by comorbidity with disruptive behavior disorders. Limitations of previous research and suggestions for future studies are discussed.
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221
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de Avila Quevedo L, Scholl CC, de Matos MB, da Silva RA, da Cunha Coelho FM, Pinheiro KAT, Pinheiro RT. Suicide Risk and Mood Disorders in Women in the Postpartum Period: a Longitudinal Study. Psychiatr Q 2021; 92:513-522. [PMID: 32812142 DOI: 10.1007/s11126-020-09823-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Suicide associated with severe psychiatric illnesses is considered the leading cause of maternal deaths. We aimed to assess the suicide risk in women who experienced depressive or mixed episodes of mood change during the postpartum period and to determine which disorder is more related to suicide risk in the same period. We conducted a longitudinal study with 706 women whose children were born from April 2007 to May 2008 in a southern city in Brazil, and received prenatal care by the Brazilian National System of Public Health. The first assessment occurred during the prenatal period and the second within 30 to 60 days postpartum. The incidence of suicide risk was 10.9%. The odds of postpartum suicide risk were 6.50 (95% CI: 2.73; 15.48) higher in mothers with postpartum depression and 41.50 (95% CI: 12.11; 142.16) higher in those with mixed episodes than those who did not suffer from any mood disorder. Women with chronic episodes (who had depressive or mixed episodes during pregnancy and postpartum) were at increased odds of 4.94 (95% CI: 1.46; 16.69) of a postpartum suicide risk. The postpartum seems to be a critical period in the women's mental health. The impact of mental disorders in this period, especially mixed episodes, can increase the odds of a suicide risk onset. A good psychiatric evaluation and support during the prenatal and postpartum care may prevent the subsequent risk of suicide.
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Affiliation(s)
- Luciana de Avila Quevedo
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil.
| | - Carolina Coelho Scholl
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil
| | - Mariana Bonati de Matos
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil
| | - Ricardo Azevedo da Silva
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil
| | | | | | - Ricardo Tavares Pinheiro
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, Pelotas, RS, 96015-560, Brazil
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222
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Denollet J, Trompetter HR, Kupper N. A review and conceptual model of the association of Type D personality with suicide risk. J Psychiatr Res 2021; 138:291-300. [PMID: 33882425 DOI: 10.1016/j.jpsychires.2021.03.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
The role of personality as distal risk factor for suicidal thoughts and behavior is still unclear. This review aims to propose two conceptual models that explain the psychological plausibility of Type D personality as distal risk factor and contributor to the transition from general to suicide distress. To support this aim, we performed a systematic review of existing studies on the association between Type D personality and suicidal distress. A systematic search yielded eight studies that reported on Type D personality and suicidal distress. Type D personality was robustly associated with suicidal thoughts and behaviors, across populations and countries. Type D was related to the level/frequency of suicidal ideation in seven studies, and suicide attempt in two studies. Our first theoretical model identifies intra-psychic (depression, alcohol misuse, posttraumatic stress) and interpersonal (low belonging, social isolation, lack of support) vulnerabilities of individuals with Type D that may fuel the development of suicidal thoughts and behaviors. Type D by itself will not account for why people become suicidal, but our second theoretical model suggests that the avoidant-passive tendencies of Type D individuals may result in persistent problem-solving deficits, and, eventually, feelings of entrapment that may contribute to the desire to escape from pain. We conclude that empirical evidence supports the hypothesized link between Type D personality, and suicidal thoughts and behaviors. Our conceptual models - albeit often supported by indirect evidence - further substantiate the plausibility of this link, and offer concrete guidance for future studies. Primarily, more longitudinal research is necessary.
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Affiliation(s)
- Johan Denollet
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
| | - Hester R Trompetter
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands.
| | - Nina Kupper
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
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223
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Hvidkjaer KL, Ranning A, Madsen T, Fleischer E, Eckardt JP, Hjorthøj C, Cerel J, Nordentoft M, Erlangsen A. People exposed to suicide attempts: Frequency, impact, and the support received. Suicide Life Threat Behav 2021; 51:467-477. [PMID: 33258173 DOI: 10.1111/sltb.12720] [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: 05/06/2020] [Revised: 06/24/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Little is known about people who have been exposed to a suicide attempt by someone they know. The purpose of this study was to examine how many people have been exposed to a suicide attempt by someone they knew and whether the exposure was associated with general well-being and suicidal ideation. METHOD A population-based online survey was conducted during 2019 in Denmark (n = 6,191). The associations between exposures to suicide attempt and general well-being (WHO-5) and suicidal ideation (Suicidal Ideation Attributes Scale) were examined using linear regression analyses. RESULTS Overall, 24.6% reported having experienced a suicide attempt by someone they knew. Of those, 46.5% had experienced a suicide attempt of a close relation and this group reported having been more affected by the event. Those exposed scored lower on general well-being (b: -3.0; 95% CI: -4.2 to -1.8; p > 0.001) and higher on suicidal ideation (b: 1.6; 95% CI: 1.3 - 1.9; p = 0.001) than those not exposed. Half of the exposed reported not having received sufficient support after the event. CONCLUSION Suicide attempt affects a substantial share of the population, and it might be relevant to ensure that support is available for those exposed perceived to be in need of support.
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Affiliation(s)
| | - Anne Ranning
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.,Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital
| | - Trine Madsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.,Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital
| | - Elene Fleischer
- Network for the Affected by Suicidal Behavior (NEFOS, Odense, Denmark
| | - Jens Peter Eckardt
- Research Unit at Bedre Psykiatri (Better Psychiatry, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.,Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.,Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
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Lawes JC, Peden AE, Bugeja L, Strasiotto L, Daw S, Franklin RC. Suicide along the Australian coast: Exploring the epidemiology and risk factors. PLoS One 2021; 16:e0251938. [PMID: 34015048 PMCID: PMC8136651 DOI: 10.1371/journal.pone.0251938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/05/2021] [Indexed: 01/22/2023] Open
Abstract
Suicide is an increasing global concern with multiple risk factors, yet location-based understanding is limited. In Australia, surf lifesavers (SLS) and lifeguards patrol the coast, performing rescues and assisting injured people, including people who suicide. This study is a descriptive epidemiological analysis of Australian coastal suicide deaths. The results will be used to inform training and support surf lifesaving personnel and suicide prevention organisations. This is a population-based cross-sectional study of suicide deaths at Australian coastal locations (between 1 January 2005 and 31 December 2019). Data were sourced from the National Coronial Information System and SLS Australia's Incident Report Database. Analyses explored decedent, incident, and risk factors by sex and method. Across the study period, there were 666 coastal suicide deaths (71.0% male, 43.4% jumping from high places [X80]). Males were more likely to suicide by other means (hanging, self-poisoning, firearm discharge; n = 145, 83.8%), compared to females who were more likely to suicide by drowning ([X71]; n = 77, 37.7%). In one third (n = 225, 38.3%) toxicology was a contributing factor. The risk of coastal suicides was 10.3 times higher during the seven-days prior to their birthday (p<0.001). Evidence of mental ill health was reported in 61.4% (n = 409) of cases and evidence of suicidal behaviour was reported for 37.4% of decedents (n = 249), more prevalent in females. SLS responded in 10.7% (n = 71) of coastal suicides (most jumps from high places; n = 36, 50.7%). Coastal suicides differ to national trends suggesting that location-based differences should be considered during development of preventative and protective measures, especially at a community level. Accessibility, availability, perceived lethality and symbolic qualities are proposed to influence suicide location decisions. These results will guide support and education strategies for surf lifesaving personnel, contributes to established, ongoing suicide surveillance efforts (including hot-spot identification) and add to the limited literature exploring place-based suicide.
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Affiliation(s)
- Jasmin C. Lawes
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Amy E. Peden
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- School of Population Health, Faculty of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
- Monash Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Luke Strasiotto
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Shane Daw
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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225
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Cunningham KC, Aunon FM, Patel TA, Mann AJ, DeBeer BB, Meyer EC, Morissette SB, Silvia PJ, Gratz KL, Calhoun PS, Beckham JC, Kimbrel NA. Nonsuicidal Self-Injury Disorder, Borderline Personality Disorder, and Lifetime History of Suicide Attempts among Male and Female Veterans with Mental Health Disorders. J Affect Disord 2021; 287:276-281. [PMID: 33799048 PMCID: PMC9004586 DOI: 10.1016/j.jad.2021.03.033] [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: 02/24/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Expanding on research that has identified nonsuicidal self-injury (NSSI) as a strong predictor of suicide risk, the present study examined NSSI disorder (NSSID) and borderline personality disorder (BPD) as unique contributors to lifetime suicide attempts. To our knowledge, the present study represents the first exploration of these associations among veterans. METHODS Participants included 124 male (74%) and female (26%) veterans diagnosed with at least one mental health disorder. Posttraumatic stress disorder (93%) and major depression (86%) were the most common mental health diagnoses. Large proportions of the sample met criteria for NSSID (48%) and BPD (40%). Suicide attempts were reported by 28% of the sample. Chi-square tests determined the bivariate associations among NSSID, BPD, history of suicide attempts, and other variables. Significant diagnostic (i.e., MDD, BPD, and NSSID) and demographic (i.e., age) characteristics were included as covariates in a logistic regression model examining the associations of BPD and NSSID with suicide attempts. RESULTS BPD, Χ2=11.1, p<0.001, and NSSID, Χ2=13.9, p<0.001, were uniquely associated with suicide attempts. When all significant predictors were included in the final model, only NSSID emerged as a significant contributor to suicide attempts, OR = 4.9, p < 0.001. LIMITATIONS Causality cannot be determined from cross-sectional analyses. CONCLUSION These findings highlight NSSID as a powerful and unique correlate of suicide attempts among veterans, beyond the associations of established diagnostic risk factors. Improving our understanding of the relationship between NSSID and suicide risk has the potential to inform suicide prevention efforts and improve clinical outcomes among veterans.
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Affiliation(s)
| | | | - Tapan A. Patel
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Adam J. Mann
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bryann B. DeBeer
- VA Rocky Mountain Mental Illness, Research, Education, and Clinical Center, Aurora, CO,Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado
| | - Eric C. Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh
| | - Sandra B. Morissette
- VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System, Waco, TX, USA,Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Paul J. Silvia
- Department of Psychology, University of North Carolina at Greensboro, NC, USA
| | - Kim L. Gratz
- Department of Psychology, University of Toledo, OH, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Corresponding author at: Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Health Care System, 3022 Croasdaile Drive, Durham, NC, 27705. (N.A. Kimbrel)
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226
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Onoya ED, Makwakwa NL, Motloba DP. Temporal variation in suicide in peri-urban Pretoria. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 34082560 PMCID: PMC8377945 DOI: 10.4102/safp.v63i1.5260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 03/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Suicide is a public health problem, and the third major cause of death in Indian, black and mixed race groups. In whites suicide is the second cause of death. The patterns of suicide vary by time of day, day of the week, month of the year and seasons. As a result of limited and inaccurate data, these variations have not been fully examined in the developing world. This study investigated the diurnality and seasonality of suicide in peri-urban Pretoria, as opposed to studies conducted previously in the country’s metropolitan. Methods A retrospective analysis of suicides recorded between 2007 and 2019 was undertaken. Data were extracted from the forensic pathology department’s database (university mortuary). Results Of the 1515 cases of suicides examined, majority were black Africans (95.9%), male (83.9%), aged 21–40 years (50.5%). Hanging was the most common method of suicide irrespective of demographics (72.8%). Diurnal suicide variations were distinct for men and women, occurring at (16:00–20:00) and (08:00–12:00), respectively. Suicide peaked on days preceding and after the weekend (Mondays and Fridays) and in warmer seasons (summer and spring) Conclusion The overall patterns of suicide in peri-urban Pretoria, mimic local and global trends with regard to methods, demographics and temporal characteristics. The underlying mechanism for these trends is unclear requiring in-depth investigation in order to develop appropriate interventions.
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Affiliation(s)
- Eric D Onoya
- Department of Forensic Pathology, School of Medicine, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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227
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Jeong T. Do more stress and lower family economic status increase vulnerability to suicidal ideation? Evidence of a U-shaped relationship in a large cross-sectional sample of South Korean adolescents. PLoS One 2021; 16:e0250794. [PMID: 33901265 PMCID: PMC8075251 DOI: 10.1371/journal.pone.0250794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/13/2021] [Indexed: 11/23/2022] Open
Abstract
It is widely held in socio-behavioral studies of suicide that higher levels of stress and lower levels of economic status amplify suicidal vulnerability when confronted with a proximal stressor, reflecting the traditionally prevalent understanding in health psychology and sociology that associates adverse life circumstances with undesirable mental health outcomes. However, upon reflection, there are strong theoretical reasons to doubt that having more stress or being in a more stressful environment always increases suicidal vulnerability given the occurrence of a crisis. Using large nationally representative public survey data on South Korean adolescents, I show that the association between recent psychosocial crisis and suicidal ideation often gets stronger with more favorable levels of perceived stress and improving levels of family economic status. Overall, the increase in the probability of suicidal ideation from recent exposure to a psychosocial crisis is consistently the smallest around medium levels of stress or family economic status and larger at low or high levels. A supplementary exercise suggests that the identified moderation effects operate mainly in virtue of individual-level stress or family economic status in the relative absence of contextual influences at the school level. The findings present preliminary evidence of the stress inoculation hypothesis with regard to suicidal ideation. Research on suicidal vulnerability could benefit from increased attentiveness to the mechanisms through which being in an adverse or unfavorable life situation could protect against the suicide-inducing effects of proximal stressors.
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Affiliation(s)
- Tay Jeong
- Department of Sociology, McGill University, Montreal, Quebec, Canada
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228
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Armoon B, SoleimanvandiAzar N, Fleury MJ, Noroozi A, Bayat AH, Mohammadi R, Ahounbar E, Fattah Moghaddam L. Prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among people with substance use disorders: a systematic review and meta-analysis. J Addict Dis 2021; 39:550-569. [PMID: 33896407 DOI: 10.1080/10550887.2021.1912572] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We assessed the prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among patients with substance use disorders (SUD). Studies in English published from January 1, 1995 to December 31, 2020 were searched on PubMed, Scopus, Cochrane and Web of Science to identify studies on variables associated with suicidal behaviors (ideations and attempts) among patients with SUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria: (i) population: patients with SUD; (ii) intervention: suicide behaviors in the past year; (iii) comparator: SUD who had not suicide behaviors; (iv) outcome: suicide ideations or attempts in the last year; and (v) study type: cross-sectional, cohort, and case-control studies. Out of 10,810 articles, 48 studies met eligibility criteria. Our findings showed a pooled prevalence rate of suicide ideations of 35% (95% CI, 22% 48%) and suicide attempts of 20% (95% CI, 17% 23%) in the last year among patients with SUD. Smoking, previous history of sexual abuse, depression, and alcohol and cannabis use disorders were significantly associated with suicide ideations. Study findings also showed that being female, smoking, history of physical and sexual abuse, depression and alcohol, cannabis, cocaine, amphetamine use disorders, and polysubstance abuse were significantly associated with suicide attempts among patients with SUD. These findings have implications for developing prevention programs. Appropriate initiatives for reducing the risk of suicide behaviors like systematic assessments of changes in drug use pattern at the emergency departments or at other key health providers may be more broadly implemented. Motivational therapy to improve help-seeking, increased information on adverse consequences of heavy substance use, and crisis plan resolutions to face suicide behaviors could also be consolidated.
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Affiliation(s)
- Bahram Armoon
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Neda SoleimanvandiAzar
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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229
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Persett PS, Ekeberg Ø, Jacobsen D, Bjornaas MA, Myhren H. Higher Suicide Intent in Patients Attempting Suicide With Violent Methods Versus Self-Poisoning. CRISIS 2021; 43:220-227. [PMID: 33890826 PMCID: PMC9102881 DOI: 10.1027/0227-5910/a000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Suicidal intent for patients attempting suicide using violent methods (VMs) is assumed to be higher than for those using self-poisoning (SP), which may explain the higher mortality observed in follow-up studies. However, this has not been studied prospectively. Aims: We aimed to compare patients attempting suicide using VMs with those using SP regarding suicidal intent, suicidal ideation, depression, and hopelessness during hospital stay and after 1 year. Methods: Patients hospitalized after suicide attempt by VMs (n = 80) or SP (n = 81) completed the Beck scales for Suicide Intent, Suicide Ideation, Depression Inventory, and Hopelessness on admission and at the 12-month follow-up. Results: On admission, those using VMs had higher suicidal intent than those using SP (M = 16.2 vs. 13.3, p < .001), but lower depression scores (M = 22.2 vs. 26.8, p < .05). No significant differences were found in suicidal ideation (M = 20.1 vs. 23.1) or hopelessness (M = 10.1 vs. 11.9). At 12-month follow-up, depression scores decreased significantly for both groups, while hopelessness decreased only for the SP group. Limitations: The statistical power achieved was lower than intended. Conclusion: The higher levels of suicidal intent, but lower levels of depression, may indicate more impulsivity among people attempting suicide using VMs. Suicidal ideation was relatively stable.
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Affiliation(s)
| | - Øivind Ekeberg
- Divisions of Mental Health and Addiction, Oslo University Hospital, Norway.,Department of Behavioral Sciences in Medicine, University of Oslo, Norway
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital, Norway.,Institute of Clinical Sciences, University of Oslo, Norway
| | | | - Hilde Myhren
- Department of Acute Medicine, Oslo University Hospital, Norway
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230
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Kim H, Kim Y, Myung W, Fava M, Mischoulon D, Lee U, Lee H, Na EJ, Choi KW, Shin MH, Jeon HJ. Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea. Sleep 2021; 43:5581583. [PMID: 31586200 DOI: 10.1093/sleep/zsz235] [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] [Received: 12/09/2018] [Revised: 08/04/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate the association between zolpidem prescription and suicide attempts in people with depression. METHODS A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. RESULTS In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58-191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99-174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50-28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21-18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. CONCLUSIONS Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.
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Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yuwon Kim
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Unjoo Lee
- Department of Electronic Engineering, Hallym University, Kangwon, South Korea
| | - Hyosang Lee
- Department of Brain and Cognitive Sciences, DGIST, Daegu, South Korea
| | - Eun Jin Na
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Korean Psychological Autopsy Center (KPAC), Seoul, South Korea
| | - Kwan Woo Choi
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Psychiatry, Anam Hospital, Korea University College of Medicine and School of Medicine, Seoul, South Korea
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Korean Psychological Autopsy Center (KPAC), Seoul, South Korea.,Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
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231
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Costanza A, Radomska M, Bondolfi G, Zenga F, Amerio A, Aguglia A, Serafini G, Amore M, Berardelli I, Pompili M, Nguyen KD. Suicidality Associated With Deep Brain Stimulation in Extrapyramidal Diseases: A Critical Review and Hypotheses on Neuroanatomical and Neuroimmune Mechanisms. Front Integr Neurosci 2021; 15:632249. [PMID: 33897384 PMCID: PMC8060445 DOI: 10.3389/fnint.2021.632249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Deep brain stimulation (DBS) is a very well-established and effective treatment for patients with extrapyramidal diseases. Despite its generally favorable clinical efficacy, some undesirable outcomes associated with DBS have been reported. Among such complications are incidences of suicidal ideation (SI) and behavior (SB) in patients undergoing this neurosurgical procedure. However, causal associations between DBS and increased suicide risk are not demonstrated and they constitute a debated issue. In light of these observations, the main objective of this work is to provide a comprehensive and unbiased overview of the literature on suicide risk in patients who received subthalamic nucleus (STN) and internal part of globus pallidum (GPi) DBS treatment. Additionally, putative mechanisms that might be involved in the development of SI and SB in these patients as well as caveats associated with these hypotheses are introduced. Finally, we briefly propose some clinical implications, including therapeutic strategies addressing these potential disease mechanisms. While a mechanistic connection between DBS and suicidality remains a controversial topic that requires further investigation, it is of critical importance to consider suicide risk as an integral component of candidate selection and post-operative care in DBS.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva (UNIGE), Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Francesco Zenga
- Department of Neurosurgery, University and City of Health and Science Hospital, Turin, Italy
| | - Andrea Amerio
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, MA, United States
| | - Andrea Aguglia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Khoa D Nguyen
- Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, United States.,Tranquis Therapeutics, Palo Alto, CA, United States.,Hong Kong University of Science and Technology, Hong Kong, China
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232
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Alberdi-Páramo Í, Díaz-Marsá M, Saiz González MD, Carrasco Perera JL. Antisocial Traits and Neuroticism as Predictors of Suicidal Behaviour in Borderline Personality Disorder: a Retrospective Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00045-7. [PMID: 33840500 DOI: 10.1016/j.rcp.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/12/2021] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. METHODS A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. RESULTS Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. CONCLUSIONS The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.
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Affiliation(s)
- Íñigo Alberdi-Páramo
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.
| | - Marina Díaz-Marsá
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; CIBERSAM, Departamento de Psiquiatría, Universidad Complutense de Madrid, Madrid, España
| | - María Dolores Saiz González
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - José Luis Carrasco Perera
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; CIBERSAM, Departamento de Psiquiatría, Universidad Complutense de Madrid, Madrid, España
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233
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Kim AM. Suicide rates by occupation in Korea, 1993-2017: the impacts of financial crisis and suicide policy. Psychiatry Res 2021; 298:113787. [PMID: 33667945 DOI: 10.1016/j.psychres.2021.113787] [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: 07/09/2020] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
This study compared the suicide rates among different groups of occupations in Korea and their changes from 1993 through 2017. The suicide rate tended to be low in the high skill occupations except the manager group. The suicide rates showed increases around the financial crises of 1997 and 2008 in most occupations, and the sharpest increase was observed in the managers. The suicide rate in the manager group, which was the lowest among all occupation groups until the mid 2000s, showed the sharpest increase and became the highest since 2012 among all occupation groups. The sustained reduction in suicide rates among the skilled agricultural, forestry and fishery workers in Korea, following the implementation of paraquat control since 2005, shows that means restriction is an effective and essential way for reducing suicides. While more efforts should be put into means restriction, policy makers should focus on changing public perceptions of suicide in order that it would not be accepted as a possible solution for the difficulties in life.
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Affiliation(s)
- Agnus M Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, 103 Daehangno, Jongno-gu, Seoul 03080, Korea.
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234
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Chen X, Wang M, Hu Y, Zhan Y, Zhou Y, Zheng W, Liu W, Wang C, Zhong X, Li H, Lan X, Ning Y, Zhang B. Working memory associated with anti-suicidal ideation effect of repeated-dose intravenous ketamine in depressed patients. Eur Arch Psychiatry Clin Neurosci 2021; 271:431-438. [PMID: 33386430 DOI: 10.1007/s00406-020-01221-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Suicide is a tremendous threat to global public health, and a large number of people who committed suicide suffered the pain of mental diseases, especially major depressive disorder (MDD). Previous study showed that ketamine could reduce suicidal ideation (SI), potentially by improving the impaired working memory (WM). The objective of current study was to illuminate the relationship between WM and SI in MDD with repeated ketamine treatment. MDD patients with SI (n = 59) and without SI (n = 37) completed six intravenous infusions of ketamine (0.5 mg/kg over 40 min) over 12 days (Day 1, 3, 5, 8, 10 and 12). The severity of depressive symptoms, SI and WM were assessed at baseline, day 13 and day 26. We found that WM was significantly improved after 6 ketamine infusions (F = 161.284, p = 0.009) in a linear mixed model. Correlation analysis showed that the improvement of depressive symptom was significantly associated with WM at baseline (r = - 0.265, p = 0.042) and the reduction in SSI-part I was related to the change of WM (r = 0.276, p = 0.034) in the MDD patients with SI. Furthermore, Logistic regression analysis showed that improvement in WM might predict the anti-SI response of ketamine. Our findings suggest that the improvement of working memory may partly account for the anti-SI effect of ketamine, and intervention of improving working memory function may be capable of reducing suicidal ideation.
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Affiliation(s)
- Xiaoyu Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Mingqia Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yiru Hu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanni Zhan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Weijian Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Hanqiu Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China. .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China.
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
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235
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Kim JS, Kim S, Lee HS, Kwon YJ, Lee HY, Shim SH. Auditory evoked potentials and suicidal behaviors in patients with major depressive disorders. Sci Rep 2021; 11:7255. [PMID: 33790320 PMCID: PMC8012352 DOI: 10.1038/s41598-021-86602-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/15/2021] [Indexed: 11/09/2022] Open
Abstract
Loudness dependence of auditory evoked potentials (LDAEP) has been proposed as a biological marker of central serotonergic activity related to suicides. This study’s objective was to analyze the difference in LDAEP between depressed patients with suicide attempts (SA) and suicidal ideation (SI). It included 130 participants (45 depressed patients with SA, 49 depressed patients with SI, and 36 healthy controls) aged > 18 years who exhibited LDAEP during electroencephalography. Psychological characteristics and event-related potentials of the three groups were compared. There was no significant difference in LDAEP between major depressive disorder (MDD) patients with SA and SI (p = 0.59). MDD patients with SI, who attempted suicide had significantly lower LDAEP than healthy controls (p = 0.01 and p = 0.01, respectively). However, the significance disappeared when psychological characteristics were controlled. Our results suggest that LDAEP might not be possible biomarkers for suicidal behaviors in patients with MDD. Further studies to assess the biological basis of suicide and identify the underlying dimensions that mediate the relationship between the biological basis and suicidal behaviors will be needed.
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Affiliation(s)
- Ji Sun Kim
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan-si, 15588, South Korea
| | - Ho-Sung Lee
- Department of Pulmonology and Allergy, Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Hwa Young Lee
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea.
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236
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Tae H, Chae JH. Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality. Front Psychiatry 2021; 12:565358. [PMID: 33868033 PMCID: PMC8044867 DOI: 10.3389/fpsyt.2021.565358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/25/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: The purpose of this article was to identify independent factors associated with suicide attempts in patients with depression and/or anxiety. Background and Aims: This study was conducted in order to examine whether risk and protective psychological factors influence the risk of suicide attempts among outpatients with anxiety and/or depressive disorders. In this regard, explanatory models have been reported to detect high-risk groups for suicide attempt. We also examined whether identified factors serve as mediators on suicide attempts. Materials and Methods: Patients from 18 to 65 years old from an outpatient clinic at Seoul St. Mary's Hospital were invited to join clinical studies. From September 2010 to November 2017, a total of 737 participants were included in the final sample. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12), and Functional Social Support Questionnaire (FSSQ) were used to assess psychiatric symptoms. An independent samples t-test, a chi-square test, hierarchical multiple regression analyses, and the Baron and Kenny's procedures were performed in order to analyze data. Results: Young age, childhood history of emotional and sexual abuse, depression, and a low level of spirituality were significant independent factors for increased suicide attempts. Depression was reported to mediate the relationship between childhood emotional and sexual abuse, spirituality, and suicide attempts. Conclusions: Identifying the factors that significantly affect suicidality may be important for establishing effective plans of suicide prevention. Strategic assessments and interventions aimed at decreasing depression and supporting spirituality may be valuable for suicide prevention.
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Affiliation(s)
- Hyejin Tae
- Stress Clinic, Health Promotion Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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237
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Position sensitive measurement of trace lithium in the brain with NIK (neutron-induced coincidence method) in suicide. Sci Rep 2021; 11:6823. [PMID: 33767316 PMCID: PMC7994404 DOI: 10.1038/s41598-021-86377-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/15/2021] [Indexed: 12/22/2022] Open
Abstract
Mood disorder is the leading intrinsic risk factor for suicidal ideation. Questioning any potency of mood-stabilizers, the monovalent cation lithium still holds the throne in medical psychiatric treatment. Furthermore, lithium`s anti-aggressive and suicide-preventive capacity in clinical practice is well established. But little is still known about trace lithium distribution and any associated metabolic effects in the human body. We applied a new technique (neutron-induced coincidence method “NIK”) utilizing the 6Li(n,α)3H reaction for the position sensitive, 3D spatially resolved detection of lithium traces in post-mortem human brain tissue in suicide versus control. NIK allowed, for the first time in lithium research, to collect a three dimensional high resolution map of the regional trace lithium content in the non lithium-medicated human brain. The results show an anisotropic distribution of lithium, thus indicating a homeostatic regulation under physiological conditions as a remarkable link to essentiality. In contrast to suicide we could empirically prove significantly higher endogenous lithium concentrations in white compared to gray matter as a general trend in non-suicidal individuals and lower lithium concentrations in emotion-modulating regions in suicide.
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238
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Matthay EC, Farkas K, Goin DE, Rudolph KE, Pear VA, Ahern J. Associations of firearm dealer openings with firearm self-harm deaths and injuries: A differences-in-differences analysis. PLoS One 2021; 16:e0248130. [PMID: 33735181 PMCID: PMC7971548 DOI: 10.1371/journal.pone.0248130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Firearm dealer density is correlated with firearm interpersonal violence, but no quasi-experimental studies have assessed whether changes in dealer density lead to changes in firearm self-harm injuries and deaths. We assessed whether openings of firearm dealers are associated with short-term changes in local firearm self-harm injury rates. METHODS We identified 718 openings of firearm dealers in California using licensing data, 2014-2016. We defined exposure regions based on aggregations of zip codes defined by proximity to firearm dealer openings and matched each opening to four control regions on time and determinants of firearm injury. We applied a differences-in-differences approach to compare rates of firearm self-harm, in the month before and after each opening, in places with and without openings. RESULTS Firearm dealer openings were not associated with acute, local changes in firearm self-harm relative to places without openings (ratio of rate ratio: 0.90 [95% CI:0.68-1.19]). Results were robust to numerous sensitivity and secondary analyses. CONCLUSION We found no associations of firearm dealer openings with acute, localized firearm self-harm deaths and injuries. Our focus on acute, local effects; broad availability of dealers and firearms; durability of firearms; or strong confounding-control may explain these null findings.
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Affiliation(s)
- Ellicott C. Matthay
- Center for Health and Community, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Kriszta Farkas
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Dana E. Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Kara E. Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Veronica A. Pear
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Jennifer Ahern
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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239
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Longitudinal exposure assessments of neighbourhood effects in health research: What can be learned from people's residential histories? Health Place 2021; 68:102543. [PMID: 33676125 DOI: 10.1016/j.healthplace.2021.102543] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/10/2023]
Abstract
Health research into neighbourhood effects has generally examined neighbourhoods cross-sectionally, ignoring the fact that neighbourhood exposures might accumulate over people's lives and affect health outcomes later in life. Using longitudinal Dutch register data with complete 15-year residential address histories, we examined whether health effects of neighbourhood socioeconomic characteristics differ between cumulative and current exposures. We illustrated these differences between exposure assessments using suicide mortality among middle-aged adults. All suicides aged 40-64 years between 2012 and 2016 were matched with 10 random controls in a nested case-control design. We measured neighbourhood exposures longitudinally for circular buffers around residential addresses at the current address and through three accumulative measures, each incorporating the residential address history with increasing detail. Covariate-adjusted conditional logistic regressions were used to assess associations between suicide and neighbourhood social fragmentation, population density and unemployment rate. Our results showed that total and male suicide mortality was significantly lower in highly fragmented neighbourhoods when using accumulative exposures, but not when using the current residential address. However, we observed few differences in coefficients between exposures assessments for neighbourhood urbanicity and unemployment rate. None of the neighbourhood characteristics showed evidence that detailed cumulative exposures were a stronger predictor of suicide compared to more crude measures. Our findings provide little evidence that socioeconomic neighbourhood characteristics measured cumulatively along people's residential histories are stronger predictors of suicide mortality than cross-sectional exposures.
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240
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Spiecker EM, Mincoff Barbanti PC, Egger PA, de Barros Carvalho MD, Pelloso SM, Rovery de Souza M, de Andrade L, Staton CA, Alves ML, Menezes de Souza E, Pedroso RB, Nickenig Vissoci JR. Influence of the global crisis of 2008 and the brazilian political oscillations of 2014 on suicide rates: An analysis of the period from 2002 to 2017. SSM Popul Health 2021; 13:100754. [PMID: 33665336 PMCID: PMC7905182 DOI: 10.1016/j.ssmph.2021.100754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/31/2020] [Accepted: 02/07/2021] [Indexed: 11/25/2022] Open
Abstract
Global suicide rates have increased in recent decades becoming a serious social and public health problem. In Brazil, rates have been increasing annually. We aimed to analyze the correlation between suicide mortality rates and global economic and political crisis periods of 2008 and 2014 in Brazil. The analysis of suicide mortality in Brazil was done using a time-series segmented linear regression model that estimated the trend of rates over time. To obtain the model, changes in the trend of both abrupt and gradual suicide rates were investigated. The results indicate statistically significant changes showing an upward trend of suicide rates during the world economic crisis (2008-2013) and during the economic and political crisis in Brazil (2014-2017) compared to previous periods, especially at the extremes of schooling (3 < years and > 8 years). Among white and parda, there were significant trend rates increases in both periods and in different regions. In the Northeast and South regions, we observed a significant increase in the trend rate for males after the Brazilian economic and political crisis (2014 to 2017). We can conclude that the national suicide rates were influenced by the economic and political instability that our country has been going through since 2008, affecting each region differently. Further studies are needed to explore the reasons for interregional differences and the relation of suicide with unemployment rates and possible economic predictors.
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Affiliation(s)
- Eliane Maria Spiecker
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | | | - Paulo Acácio Egger
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | - Maria Dalva de Barros Carvalho
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | - Sandra Marisa Pelloso
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | - Marta Rovery de Souza
- Department of Public Health, Federal University of Goiás, Esperança Ave, 74690-900, Goiânia, GO, Brazil
| | - Luciano de Andrade
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | - Catherine A. Staton
- Duke Global Health Institute, Duke University, 310 Trent Dr, 27710, Durham, NC, USA
- Duke Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, 27707, Durham, NC, USA
| | - Marcia Lorena Alves
- Postgraduate Program in Biostatistics, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Parana, Brazil
| | - Eniuce Menezes de Souza
- Postgraduate Program in Biostatistics, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Parana, Brazil
- Department of Statistics, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Parana, Brazil
| | - Raíssa Bocchi Pedroso
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
| | - João Ricardo Nickenig Vissoci
- Postgraduate Program in Health Sciences, State University of Maringá, 5790 Colombo Ave, 87020-900, Maringá, Paraná, Brazil
- Duke Global Health Institute, Duke University, 310 Trent Dr, 27710, Durham, NC, USA
- Duke Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, 27707, Durham, NC, USA
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241
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Chen YY, Yu S, Hu YH, Li CY, Artaud F, Carcaillon-Bentata L, Elbaz A, Lee PC. Risk of Suicide Among Patients With Parkinson Disease. JAMA Psychiatry 2021; 78:293-301. [PMID: 33326004 PMCID: PMC7745139 DOI: 10.1001/jamapsychiatry.2020.4001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Parkinson disease (PD) is an increasingly common neurodegenerative disorder in many aging societies. Although comorbidities with mental disorders are common in PD, whether PD is associated with an increased risk of suicide is unclear. OBJECTIVE To use a large national representative PD cohort to compare the risk of suicide in patients with PD and control participants and identify potential risk factors. DESIGN, SETTING, AND PARTICIPANTS This nationwide population-based cohort study used linked data from Taiwan's National Health Insurance data set and Taiwan Death Registry between January 2002 and December 2016. Patients with incident PD diagnosed between January 2005 and December 2014 were followed up until December 2016. Four control participants from the general population were randomly selected by risk set sampling and were matched on age, sex, and residence to each affected individual. Data analysis occurred from June 2019 to October 2020. EXPOSURES Diagnosis of PD retrieved from the National Health Insurance data set. MAIN OUTCOMES AND MEASURES Suicide was recorded in the Taiwan Death Registry. Cox proportional models and hazard ratios (HRs) were used to estimate the association between PD and the risk of suicide over the follow-up period. RESULTS Over 11 years, 35 891 patients with PD were followed up (17 482 women [48.7%]; mean [SD] age, 72.5 [10.1] years) and matched to 143 557 control participants (69 928 women [48.7%]; mean [SD] age, 72.5 [10.1] years). A total of 151 patients with PD (cumulative incidence, 66.6 per 100 000 [95% confidence limits [CL], 78.1-91.7]) and 300 control participants (cumulative incidence, 32.3 per 100 000 [95% CL, 36.2-40.5]) died by suicide. The risk of suicide was higher (HR, 2.1 [95% CL, 1.7-2.5]) in patients with PD than control participants, after adjustment for markers of socioeconomic position, medical comorbidities, and dementia. After controlling for mental disorders, the association between PD and suicide risk remained (HR, 1.9 [95% CL, 1.6-2.3]). Compared with control participants who died by suicide, those who died by suicide in the PD group were slightly younger (mean [SD] age: patients with PD, 74.0 [10.4] years vs control participants, 76.0 [10.2] years; P = .05) and more likely to be urban dwelling (medium urbanization, 39 patients with PD [25.8%] vs 115 control participants [38.3%]; high urbanization, 84 patients with PD [55.6%] vs 136 control participants [45.3%]; P = .03), have mental disorders (depression, 15 of 151 patients with PD [9.9%] vs 15 of 300 control participants [5.0%]; other mental disorders, 12 patients with PD [8.0%] vs 11 control participants [3.7%]; P = .02), and adopt jumping as a method of suicide (21 patients with PD [13.9%] vs 16 control participants [5.3%]; P < .01). CONCLUSIONS AND RELEVANCE In this population-based cohort study, Parkinson disease, a common neurodegenerative disorder common in elderly persons, was independently associated with an increased risk of suicide. Integrating mental health care into primary care and PD specialty care, along with socioenvironmental interventions, may help decrease the risk of suicide in patients with PD.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan,Institute of Public Health, Department of Public Health, National Yang-Ming University, Taipei City, Taiwan
| | - Sun Yu
- Department of Neurology, En Chu Kong Hospital, Sanxia District, New Taipei City, Taiwan
| | - Ya-Hui Hu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan,Department of Health Care Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Fanny Artaud
- Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Sud, Institut National de la Santé et de la Recherche Médicale Unité 1018, Team “Exposome, Heredity, Cancer and Health,” Center for Research in Epidemiology and Population Health, Villejuif, France
| | | | - Alexis Elbaz
- Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Sud, Institut National de la Santé et de la Recherche Médicale Unité 1018, Team “Exposome, Heredity, Cancer and Health,” Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Pei-Chen Lee
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan,Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan,Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, University Paris-Sud, Institut National de la Santé et de la Recherche Médicale Unité 1018, Team “Exposome, Heredity, Cancer and Health,” Center for Research in Epidemiology and Population Health, Villejuif, France
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242
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Bai S, Fang L, Xie J, Bai H, Wang W, Chen JJ. Potential Biomarkers for Diagnosing Major Depressive Disorder Patients with Suicidal Ideation. J Inflamm Res 2021; 14:495-503. [PMID: 33654420 PMCID: PMC7910095 DOI: 10.2147/jir.s297930] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background Major depressive disorder (MDD) and suicide are two major health problems, but there are still no objective methods to diagnose MDD or suicidal ideation (SI). This study was conducted to identify potential biomarkers for diagnosing MDD patients with SI. Methods First-episode drug-naïve MDD patients with SI and demographics-matched healthy controls (HCs) were recruited. First-episode drug-naïve MDD patients without SI were also included. The serum lipids, C-reactive protein (CRP), transferring (TRSF), homocysteine (HCY) and alpha 1-antitrypsin (AAT) in serum were detected. The univariate and multivariate statistical analyses were used to identify and validate the potential biomarkers. Results The 86 HCs, 53 MDD patients with SI and 20 MDD patients without SI were included in this study. Four potential biomarkers were identified: AAT, TRSF, high-density lipoprotein cholesterol (HDLC), and apolipoprotein A1 (APOA1). After one month treatment, the levels of AAT and APOA1 were significantly improved. The panel consisting of these potential biomarkers had an excellent diagnostic performance, yielding an area under the ROC curve (AUC) of 0.994 and 0.990 in the training and testing set, respectively. Moreover, this panel could effectively distinguish MDD patients with SI from MDD patients without SI (AUC=0.928). Conclusion These results showed that these potential biomarkers could facilitate the development of an objective method for diagnosing MDD patients with SI, and the decreased AAT levels in MDD patients might lead to the appearance of SI by resulting in the elevated inflammation.
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Affiliation(s)
- Shunjie Bai
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Liang Fang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Cerebral Vascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jing Xie
- Department of Endocrinology and Nephrology, The Fourth People's Hospital of Chongqing, Chongqing, People's Republic of China
| | - Huili Bai
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Wei Wang
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Jian-Jun Chen
- Institute of Life Sciences, Chongqing Medical University, Chongqing, People's Republic of China
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243
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Masi G, Berloffa S, Milone A, Brovedani P. Social withdrawal and gender differences: Clinical phenotypes and biological bases. J Neurosci Res 2021; 101:751-763. [PMID: 33550643 DOI: 10.1002/jnr.24802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/17/2021] [Indexed: 12/19/2022]
Abstract
Evidence from everyday life suggests that differences in social behaviors between males and females exist, both in animal and in humans. These differences can be related to socio-cultural determinants, but also to specialized portions of the brain (the social brain), from the neurotransmitter to the neural network level. The high vulnerability of this system is expressed by the wide range of neuropsychiatric disorders associated with social dysfunctions, particularly social withdrawal. The principal psychiatric disorders with prominent social withdrawal are described, including hikikomori-like syndromes, and anxiety, depressive, autistic, schizophrenic, and personality disorders. It is hypothesized that social withdrawal can be partially independent from other symptoms and likely reflect alterations in the social brain itself, leading to a similar, transdiagnostic social dysfunction, reflecting defects in the social brain across a variety of psychopathological conditions. An overview is provided of gender effects in the biological determinants of social behavior, including: the anatomical structures of the social brain; the dimorphic brain structures, and the modulation of their development by sex steroids; gender differences in "social" neurotransmitters (vasopressin and oxytocin), and in their response to social stress. A better comprehension of gender differences in the phenotypes of social disorders and in the neural bases of social behaviors may provide new insights for timely, focused, innovative, and gender-specific treatments.
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Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Stefano Berloffa
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Paola Brovedani
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
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244
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Can AT, Hermens DF, Dutton M, Gallay CC, Jensen E, Jones M, Scherman J, Beaudequin DA, Yang C, Schwenn PE, Lagopoulos J. Low dose oral ketamine treatment in chronic suicidality: An open-label pilot study. Transl Psychiatry 2021; 11:101. [PMID: 33542187 PMCID: PMC7862447 DOI: 10.1038/s41398-021-01230-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 01/07/2023] Open
Abstract
Recently, low-dose ketamine has been proposed as a rapid-acting treatment option for suicidality. The majority of studies to date have utilised intravenous (IV) ketamine, however, this route of administration has limitations. On the other hand, oral ketamine can be administered in a range of settings, which is important in treating suicidality, although studies as to safety and feasibility are lacking. n = 32 adults (aged 22-72 years; 53% female) with chronic suicidal thoughts participated in the Oral Ketamine Trial on Suicidality (OKTOS), an open-label trial of sub-anaesthetic doses of oral ketamine over 6 weeks. Participants commenced with 0.5 mg/kg of ketamine, which was titrated to a maximum 3.0 mg/kg. Follow-up assessments occurred at 4 weeks after the final dose. The primary outcome measure was the Beck Scale for Suicide Ideation (BSS) and secondary measures included scales for suicidality and depressive symptoms, and measures of functioning and well-being. Mean BSS scores significantly reduced from a high level of suicidal ideation at the pre-ketamine (week 0) timepoint to below the clinical threshold at the post-ketamine (week 6) timepoint. The proportion of participants that achieved clinical improvement within the first 6 weeks was 69%, whereas 50% achieved a significant improvement by the follow-up (week 10) timepoint. Six weeks of oral ketamine treatment in participants with chronic suicidality led to significant reduction in suicidal ideation. The response observed in this study is consistent with IV ketamine trials, suggesting that oral administration is a feasible and tolerable alternative treatment for chronic suicidality.
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Affiliation(s)
- Adem T. Can
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Daniel F. Hermens
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Megan Dutton
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Cyrana C. Gallay
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Emma Jensen
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Monique Jones
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Jennifer Scherman
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Denise A. Beaudequin
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Cian Yang
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Paul E. Schwenn
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
| | - Jim Lagopoulos
- grid.1034.60000 0001 1555 3415Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland Australia
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245
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Eyre-Watt B, Mahendran E, Suetani S, Firth J, Kisely S, Siskind D. The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million people. Aust N Z J Psychiatry 2021; 55:139-152. [PMID: 33045847 DOI: 10.1177/0004867420963740] [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] [Indexed: 01/28/2023]
Abstract
BACKGROUND Lithium in drinking water may have significant mental health benefits. We investigated the evidence on the association between lithium concentrations in drinking water and their neuropsychiatric outcomes. METHODS We conducted a systematic review and meta-analysis and searched Pubmed, Embase, Web of Science, PsycINFO and CINAHL up to 19 January 2020, for peer-reviewed research examining the association between lithium concentrations in drinking water and neuropsychiatric outcomes. We used a pairwise analysis and a random effects model to meta-analyse suicide rates and psychiatric hospital admissions. We assessed for publication bias using Egger's test and Duval and Tweedie's Trim and Fill analysis. RESULTS Twenty-seven studies including 113 million subjects were included in this systematic review. Meta-analysis of 14 studies including 94 million people found higher lithium concentrations were associated with reduced suicide rates (r = -0.191, 95% confidence interval = [-0.287, -0.090], p < 0.001) and meta-analysis of two studies including 5 million people found higher lithium concentrations were associated with fewer hospital admissions (r = -0.413, 95% confidence interval = [-0.689, -0.031], p = 0.035). We found significant heterogeneity between studies (Q = 67.4, p < 0.001, I2 = 80.7%) and the presence of publication bias (Egger's test; t value = 2.90, p = 0.013). Other included studies did not provide sufficient data to analyse other neuropsychiatric outcomes quantitatively. CONCLUSION Higher lithium concentrations in drinking water may be associated with reduced suicide rates and inpatient psychiatric admissions. The relationship with other neuropsychiatric outcomes and complications remains unclear. Further research is required before any public health recommendations can be made.Trial registration number: The study was registered with PROSPERO, number CRD42018090145.
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Affiliation(s)
| | | | - Shuichi Suetani
- School of Medicine, Griffith University, Southport, QLD, Australia.,Metro South Mental Health and Addiction Services, Brisbane, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Joseph Firth
- NICM Health Research Institute, School of Science and Health, Western Sydney University, Sydney, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Steve Kisely
- Metro South Mental Health and Addiction Services, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Dan Siskind
- Metro South Mental Health and Addiction Services, Brisbane, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
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246
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Optimal approaches for preventing depressive symptoms in children and adolescents based on the psychosocial interventions: A Bayesian Network Meta-Analysis. J Affect Disord 2021; 280:364-372. [PMID: 33221723 DOI: 10.1016/j.jad.2020.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/21/2020] [Accepted: 11/07/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND It is necessary to develop effective preventive interventions before depression established to alleviate depressive symptoms or delay the onset of depression. In this study, we employed Bayesian network meta-analysis to identify the optimal psychosocial intervention approach for preventing depressive symptoms in children and adolescents. METHODS We searched publication databases and conference abstracts, from time of their inception through April 2019 without language restriction, for randomized controlled trials that compared the efficacy of various psychosocial intervention approaches. We extracted the mean and standard deviation values between baseline and the last observation, and calculated the change score in depression. We also assessed ranking probability by surface under the cumulative ranking curve using a 95% credible interval. RESULTS A total of 27 randomized controlled trials, involving 5,976 participants aged between 7 to 18 years, were included in our analyses. Analysis of various valid assessment instruments indicated that computer cognitive-behavioral therapy [standard mean difference (SMD = -1.82)], cognitive-behavioral therapy (SMD = -1.54) and interpersonal psychotherapy (SMD = -1.29) were statistically superior to wait-list group. Among the approaches, computer cognitive-behavioral therapy had the highest probability of being the best intervention, based on improvement from baseline to the end of the intervention (SUCRA = 90.47%, CrI: 0.55, 1.00). LIMITATIONS The results herein may not apply to other cultures and ethnic minorities because about half of the studies included in our analysis were conducted in the United States. CONCLUSIONS Computer cognitive-behavioral therapy was the most recommended intervention to accompany the depression among children and adolescents according to our Bayesian network meta-analysis results.
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247
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Zhao Y, Wang L, Edmiston EK, Womer FY, Jiang X, Wu F, Kong L, Zhou Y, Wang F, Tang Y, Wei S. Alterations in gray matter volumes and intrinsic activity in the prefrontal cortex are associated with suicide attempts in patients with bipolar disorder. Psychiatry Res Neuroimaging 2021; 307:111229. [PMID: 33242746 DOI: 10.1016/j.pscychresns.2020.111229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/13/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is associated with increased suicidal behavior. Understanding the neural features of suicide attempts (SA) in patients with BD is critical to preventing suicidal behavior. The prefrontal cortex (PFC) is a key region related to SA. In this study, forty BD patients with a history of SA (BD+SA), 70 BD patients without a history of SA (BD-SA), and 110 individuals in a healthy control (HC) group underwent structural magnetic resonance imaging (MRI) and resting-state functional MRI. We used voxel-based morphometry (VBM) and amplitude of low frequency fluctuations (ALFF) techniques to examine the gray matter volumes (GMVs) and ALFF values in the PFC. Compared with the HC group, both the BD+SA and BD-SA groups had lower GMVs and higher ALFF values in the medial PFC (MPFC), ventral PFC (VPFC), and dorsolateral PFC (DLPFC). The ALFF values in the MPFC, VPFC, and DLPFC in the BD+SA group were significantly higher than those in the BD-SA group. These findings suggest that BD patients with SA have intrinsic activity abnormalities in PFC regions. This provides potentially identifiable neuroimaging markers in BD patients with SA that could be used to increase our understanding of suicidal behavior.
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Affiliation(s)
- Yimeng Zhao
- Department of Psychiatry, China Medical University, Shenyang, Liaoning, China; Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Lifei Wang
- Department of Psychiatry, China Medical University, Shenyang, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Elliot K Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Feng Wu
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Yifang Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Fei Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Yanqing Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China.
| | - Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China.
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Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031174. [PMID: 33525740 PMCID: PMC7908206 DOI: 10.3390/ijerph18031174] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 12/22/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.
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Worthley A, Simonyan K. Suicidal Ideations and Attempts in Patients With Isolated Dystonia. Neurology 2021; 96:e1551-e1560. [PMID: 33504639 DOI: 10.1212/wnl.0000000000011596] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the hypothesis that individuals with isolated dystonia are at an increased risk for suicidal behavior, we administered an anonymous electronic survey to patients with dystonia, asking them about their history of suicidal ideations and suicide attempt. METHODS A total of 542 patients with dystonia completed an online 97-question survey, which captured the demographics of suicidal behavior and major psychiatric disorders. Statistical analyses examined the prevalence of suicidal behavior in patients with dystonia compared to the prevalence of suicidal ideations and attempt in the general global population and assessed the significance of risk associations between suicidality and psychiatric history in these patients. RESULTS Overall, 32.3% of patients with isolated dystonia reported a lifetime history of suicidal behavior, which was significantly different from the reported rates of suicidal ideation (9.2%) and attempt (2.7%) in the general global population. The prevalence of suicidality was higher in patients with multifocal/segmental and generalized forms of dystonia (range of 46%-50%) compared to patients with focal dystonias (range of 26.1%-33.3%). The highest suicidal ideation-to-attempt ratio of 4:1 was found in patients with generalized dystonia. Suicidality in patients with focal dystonia was significantly associated with history of depression and anxiety disorders. CONCLUSION Patients with isolated dystonia have an increased, albeit unrecognized, prevalence of suicidal behavior compared to the general global population. Screening for suicidal risk should be incorporated as part of the clinical evaluation of patients with dystonia to prevent their suicide-induced injury and death.
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Affiliation(s)
- Alexis Worthley
- From the Department of Otolaryngology-Head and Neck Surgery (A.W., K.S.), Massachusetts Eye and Ear; Department of Otolaryngology-Head and Neck Surgery (K.S.), Harvard Medical School; and Department of Neurology (K.S.), Massachusetts General Hospital, Boston
| | - Kristina Simonyan
- From the Department of Otolaryngology-Head and Neck Surgery (A.W., K.S.), Massachusetts Eye and Ear; Department of Otolaryngology-Head and Neck Surgery (K.S.), Harvard Medical School; and Department of Neurology (K.S.), Massachusetts General Hospital, Boston.
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250
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The mediating role of adolescents' loneliness and social withdrawal in the association between maternal depressive symptoms and suicidality in adolescence: A 20-year population-based study. Dev Psychopathol 2021; 34:1045-1053. [PMID: 33487191 DOI: 10.1017/s0954579420001753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We examined whether adolescents' loneliness and social withdrawal mediated the association between maternal depressive symptoms and adolescent suicidality. Secondary analyses on the Québec Longitudinal Study of Child Development data were conducted (n = 1,623). Each mother completed the Centre for Epidemiologic Studies Depression Scale (at child ages 5 months, 1.5, 3.5, 5, and 7 years). Adolescent's social withdrawal (adolescent, father, and teacher reported at 10, 12, and 13 years) and loneliness (adolescent reported at 10, 12, and 13 years), were assessed using items from the Social Behavior Questionnaire and the Loneliness and Social Satisfaction Questionnaire, respectively. Adolescents completed self-reports to assess suicidal thoughts and attempts at 13, 15, 17, and 20 years. Children of mothers with higher levels of maternal depressive symptoms had an increased risk for suicidality (OR = 1.15, 95% CI: 1.03-1.28). Loneliness explained 16% of the total effect of maternal depressive symptoms on adolescent suicidality (indirect effect OR = 1.02, 95% CI: 1.00-1.04). There was no indirect effect of maternal depressive symptoms on adolescent suicidal outcomes via social withdrawal (indirect effect OR = 1.00, 95% CI: 0.99-1.02). Interventions that target loneliness may be beneficial for decreasing the risk for suicidality among adolescents of mothers with depressive symptoms.
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