201
|
May AM, Pachkowski MC, Klonsky ED. Motivations for suicide: Converging evidence from clinical and community samples. J Psychiatr Res 2020; 123:171-177. [PMID: 32078834 DOI: 10.1016/j.jpsychires.2020.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/08/2020] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
Understanding what motivates suicidal behavior is critical to effective prevention and clinical intervention. The Inventory of Motivations for Suicide Attempts (IMSA) is a self-report measure developed to assess a wide variety of potential motivations for suicide. The purpose of this study is to examine the measure's psychometric and descriptive properties in two distinct populations: 1) adult psychiatric inpatients (n = 59) with recent suicide attempts (median of 3 days prior) and 2) community participants assessed online (n = 222) who had attempted suicide a median of 5 years earlier. Findings were very similar across both samples and consistent with initial research on the IMSA in outpatients and undergraduates who had attempted suicide. First, the individual IMSA scales demonstrated good internal reliability and were well represented by a two factor superordinate structure: 1) Internal Motivations and 2) Communication Motivations. Second, in both samples unbearable mental pain and hopelessness were the most common and strongly endorsed motivations, while interpersonal influence was the least endorsed. Finally, motivations were similar in men and women -- a pattern that previous work was not in a position to examine. Taken together with previous work, findings suggest that the nature, structure, and clinical correlates of suicide attempt motivations remain consistent across diverse individuals and situations. The IMSA may serve as a useful tool in both research and clinical contexts to quickly assess individual suicide attempt motivations.
Collapse
Affiliation(s)
- Alexis M May
- Department of Psychology, Wesleyan University, Middletown, CT, USA.
| | | | - E David Klonsky
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
202
|
Ceniti AK, Heinecke N, McInerney SJ. Examining suicide-related presentations to the emergency department. Gen Hosp Psychiatry 2020; 63:152-157. [PMID: 30268506 DOI: 10.1016/j.genhosppsych.2018.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/17/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Although the Emergency Department (ED) is a frequent point of contact for individuals with suicide-related behaviour (SRB) or ideation, there is limited literature specifically examining presentations to the ED for SRB. This review examines the international literature published in North America, the United Kingdom and Australia relating to presentations to the ED for SRB, with focus on high-risk groups, screening tools used in the ED, and difficulties in classifying ED presentations of SRB. METHOD The database PubMed was searched using relevant terms, and national health care administrative data were reviewed. RESULTS Psychiatric history, substance use, and lower socioeconomic status were all found to be associated with higher rates of ED presentations for SRB. Limited research exists around ED presentations of SRB by particular high-risk groups, including lesbian, gay, bisexual, and transgender populations and Indigenous peoples. Individuals who present to EDs for SRB are often chronic users of EDs and have a high rate of repeat self-harm and death by suicide. CONCLUSION These findings suggest that EDs could serve as a focal point for suicide treatment interventions. Deepening our understanding of ED presentations for SRB could inform further development and implementation of interventions to reduce death by suicide.
Collapse
Affiliation(s)
- Amanda K Ceniti
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Heinecke
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Shane J McInerney
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada; Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, St. Michael's Hospital, University Health Network & University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
203
|
Spielmans GI, Spence-Sing T, Parry P. Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front Psychiatry 2020; 11:18. [PMID: 32116839 PMCID: PMC7031767 DOI: 10.3389/fpsyt.2020.00018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/09/2020] [Indexed: 12/23/2022] Open
Abstract
The United States Food and Drug Administration issued a Black Box warning in October 2004 after placebo-controlled trials of antidepressant medications found an increased risk of suicidal thoughts and behaviors among children and adolescents taking antidepressant medications relative to placebo. Subsequently, some researchers have concluded that the Black Box warning caused severe unintended consequences; specifically, they have argued that the warning led to reduced use of antidepressants among youth, which led to more suicides. In this paper, we critically examine research regarding the Black Box warning's alleged deleterious consequences. One study claimed that controlled trials did not actually find an increased risk of suicidality among youth taking fluoxetine relative to those taking placebo, but its measure of suicidality is likely invalid. We found that ecological time series studies claiming that decreasing antidepressant prescriptions are linked to higher rates of suicide attempts or actual suicides among youth were methodologically weak. These studies exhibited shortcomings including: selective use of time points, use of only a short-term time series, lack of performing statistical analysis, not examining level of severity/impairment among participants, inability to control confounding variables, and/or use of questionable measures of suicide attempts. Further, while some time-series studies claim that increased antidepressant prescriptions are related to fewer youth suicides, more recent data suggests that increasing antidepressant prescriptions are related to more youth suicide attempts and more completed suicides among American children and adolescents. We also note that case-control studies show increased risk of suicide attempts and suicide among youth taking antidepressants, even after controlling for some relevant confounds. As clinical trials have the greatest ability to control relevant confounds, it is important to remember such trials demonstrated increased risk of suicidality adverse events among youth taking antidepressants. The Black Box warning is firmly rooted in solid data whereas attempts to claim the warning has caused harm are based on quite weak evidence.
Collapse
Affiliation(s)
- Glen I. Spielmans
- Department of Psychology, Metropolitan State University, Saint Paul, MN, United States
| | - Tess Spence-Sing
- Department of Psychology, Metropolitan State University, Saint Paul, MN, United States
| | - Peter Parry
- School of Clinical Medicine – Children’s Health Queensland Unit, University of Queensland, Brisbane, QLD, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
204
|
Arshad U, Farhat‐ul‐Ain, Gauntlett J, Husain N, Chaudhry N, Taylor PJ. A Systematic Review of the Evidence Supporting Mobile- and Internet-Based Psychological Interventions For Self-Harm. Suicide Life Threat Behav 2020; 50:151-179. [PMID: 31448847 PMCID: PMC7027458 DOI: 10.1111/sltb.12583] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Internet- and mobile phone-based psychological interventions have the potential to overcome many of the barriers associated with accessing traditional face-to-face therapy. Self-injurious thoughts and behaviors (STB) are prevalent global health problems that may benefit from Internet- and mobile-based interventions. We provide a systematic review and meta-analysis of studies evaluating mobile- and Internet-based interventions for STB, including nonsuicidal self-injury (NSSI). METHODS Online databases (PsycINFO, Web of Science, Medline) were searched up to March 2019 for single-arm and controlled trials of Internet- or mobile-based interventions for STB. The potential for bias was assessed using the Cochrane risk of bias tool. RESULTS Twenty-two eligible trials were identified. The research was limited by a lack of controlled designs and small samples. Evidence supports the acceptability of interventions. There is preliminary evidence that these interventions are associated with a decline in STB. A meta-analysis suggested a positive treatment effect on suicidal ideation when compared to treatment as usual, but not when trials with active controls were also considered. CONCLUSIONS Overall, Internet- and mobile-based interventions show promise and further controlled trials are warranted, focusing on behavioral outcomes (NSSI, suicidal behavior). This review was preregistered with PROSPERO (CRD42017074065).
Collapse
Affiliation(s)
- Usman Arshad
- Pakistan Institute of Living & LearningKarachiPakistan
| | - Farhat‐ul‐Ain
- Pakistan Institute of Living & LearningKarachiPakistan
| | - Jessica Gauntlett
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Nusrat Husain
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| | | | - Peter James Taylor
- Division of Psychology & Mental HealthManchester Academic Health Sciences CentreSchool of Health SciencesUniversity of ManchesterManchesterUK
| |
Collapse
|
205
|
Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, Pupo S, Raballo A, Pelizza L. Familiarity for Serious Mental Illness in Help-Seeking Adolescents at Clinical High Risk of Psychosis. Front Psychiatry 2020; 11:552282. [PMID: 33488412 PMCID: PMC7819871 DOI: 10.3389/fpsyt.2020.552282] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/27/2020] [Indexed: 01/24/2023] Open
Abstract
Aim: Ultrahigh-risk (UHR) individuals have an increased vulnerability to psychosis because of accumulating environmental and/or genetic risk factors. Although original research examined established risk factors for psychosis in the UHR state, these findings are scarce and often contradictory. The aims of this study were (a) to investigate the prevalence of severe mental illness (SMI) in family members of distinct subgroups of adolescents identified through the UHR criteria [i.e., non-UHR vs. UHR vs. first-episode psychosis (FEP)] and (b) to examine any relevant associations of family vulnerability and genetic risk and functioning deterioration (GRFD) syndrome with clinical and psychopathological characteristics in the UHR group. Methods: Adolescents (n = 147) completed an ad hoc sociodemographic/clinical schedule and the Comprehensive Assessment of At-Risk Mental States to investigate the clinical status. Results: More than 60% UHR patients had a family history of SMI, and approximately a third of them had at least a first-degree relative with psychosis or other SMI. A GRFD syndrome was detected in ~35% of UHR adolescents. GRFD adolescents showed baseline high levels of positive symptoms (especially non-bizarre ideas) and emotional disturbances (specifically, observed inappropriate affect). Conclusions: Our results confirm the importance of genetic and/or within-family risk factors in UHR adolescents, suggesting the crucial need of their early detection, also within the network of general practitioners, general hospitals, and the other community agencies (e.g., social services and school).
Collapse
Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a carattere Scientifico (USL-IRCSS) di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Rocco Chiri
- Department of Primary Care, Azienda Unità Sanitaria Locale (USL) di Parma, Parma, Italy
| | - Simona Pupo
- Anesthesia and Resuscitation Service, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Andrea Raballo
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
| | - Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale (USL) di Parma, Parma, Italy
| |
Collapse
|
206
|
Amudhan S, Gururaj G, Varghese M, Benegal V, Rao GN, Sheehan DV, Kokane AM, Chavan BS, Dalal PK, Ram D, Pathak K, Lenin Singh RK, Singh LK, Sharma P, Saha PK, Ramasubramanian C, Mehta RY, Shibukumar TM. A population-based analysis of suicidality and its correlates: findings from the National Mental Health Survey of India, 2015-16. Lancet Psychiatry 2020; 7:41-51. [PMID: 31826821 DOI: 10.1016/s2215-0366(19)30404-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/17/2019] [Accepted: 10/01/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND India accounts for 18% of the global population and 26·6% of global suicide deaths. However, robust population-based, nationally representative data on suicidality are not readily available to plan and implement suicide prevention programmes in India. We aimed to investigate the prevalence and sociodemographic differentials of suicidality using data from the National Mental Health Survey (NMHS) of India, 2015-16. METHODS Trained field data collectors from the NMHS obtained information on suicidality (during the past month) from a community sample of adults aged 18 years and older using the suicidality module of the Mini-International Neuropsychiatric Interview (version 6.0). Suicidality was categorised as low, moderate, high, and overall (representing any suicidality), and examined for sociodemographic differentials using normalised sampling weights. For each of the 12 surveyed states, we calculated the age-standardised suicidality prevalence for men and women, men-to-women ratio of weighted suicidality prevalence, ratio of suicidality to suicide deaths, and ratio of suicide attempts to suicide deaths. We used logistic regression analysis to examine the association between sociodemographic factors and overall suicidality and severity. FINDINGS Among 34 748 participants with complete interviews, 5·1% (95% CI 4·7-5·6) had some level of suicidality, and 0·3% (0·2-0·4) had at least one suicide attempt in the past month. The prevalence of overall suicidality was higher in women (6·0% [5·4-6·6]) than in men (4·1% [3·7-4·6]). The prevalence of overall suicidality was highest in those aged 40-49 years among women and in those aged 60 years or older among men. Compared with their counterparts, individuals with lower educational attainment, individuals residing in urban metropolitan cities, individuals who were widowed, separated, or divorced, and unemployed individuals had a higher prevalence of overall suicidality. The men-to-women ratio of overall suicidality prevalence for India was 0·68 (range 0·55-0·85). For every death by suicide in India, there were more than 200 people with suicidality and more than 15 suicide attempts. We found variations for various severities of suicidality. We found an increased risk for overall suicidality in women versus men (odds ratio [OR] 1·54 [95% CI 1·31-1·81]; p<0·0001) and in individuals residing in urban metropolitan cities versus those residing in rural areas (1·75 [1·30-2·35]; p=0·0002). Individuals belonging to the lowest income quintile (reference group with OR <1·00 and p<0·05 for other income quintiles), those with depressive disorders (28·78 [20·04-41·33]; p<0.0001) and those with alcohol use disorders (6·52 [3·83-11·10]; p<0.0001) had an increased risk for high suicidality, compared with their corresponding counterparts. INTERPRETATION A national suicide prevention strategy that is comprehensive, using multisectoral approaches, is required to address the prevailing sociodemographic and other risk factors for reducing suicidality and suicide deaths in India. This study also has implications for other low-income and middle-income countries in south Asia, where sociodemographic factors play a crucial role for suicide prevention. FUNDING Ministry of Health and Family Welfare, Government of India.
Collapse
Affiliation(s)
- Senthil Amudhan
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Girish Nagaraja Rao
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | - Arun Mahadeo Kokane
- Department of Community Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, India
| | - Kangkan Pathak
- Department of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, India
| | | | - Lokesh Kumar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India
| | - Pradeep Sharma
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
| | | | | | | | | |
Collapse
|
207
|
Development and psychometric properties of the "Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales" in adolescents. Eur Child Adolesc Psychiatry 2020; 29:153-165. [PMID: 31054125 PMCID: PMC7024696 DOI: 10.1007/s00787-019-01328-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 04/01/2019] [Indexed: 11/25/2022]
Abstract
Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity-the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test-retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS-the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = - 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents.
Collapse
|
208
|
Amini-Tehrani M, Nasiri M, Jalali T, Sadeghi R, Ghotbi A, Zamanian H. Validation and psychometric properties of Suicide Behaviors Questionnaire-Revised (SBQ-R) in Iran. Asian J Psychiatr 2020; 47:101856. [PMID: 31704597 DOI: 10.1016/j.ajp.2019.101856] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/27/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Suicide is increasing in young Iranian population, which necessitates the employing of valid, yet abridged instruments assessing the constellation of suicide-related behaviors. The study aimed at validating Suicide Behavior Questionnaire-Revised (SBQ-R) among Iranian undergraduates. METHODS A total of 487 undergraduates were surveyed in 2018. Construct validity of SBQ-R was examined via confirmatory factor analysis (CFA), and Spearman's correlation with two single-item indices of suicide acceptability (SA) and lifetime suicidal ideation (LSI) was determined. Logistic regression and Kruskal-Wallis tests were used to examine the cut-off points (≥ 7 and ≥ 8) and categorizations as per item 1. RESULTS The mean SBQ-R score was 5.79 ± 3.55. Cut-off points ≥ 7 and ≥ 8 categorized 150 (30.8%) and 123 (25.2%) samples with suicide risk, respectively. Women obtained significantly higher scores on all indices, except items 1 and 4. CFA confirmed the model with sound goodness-of-fit, with factor loadings of 0.70 to 0.83. Composite reliability and average variance extracted were 0.87 and 0.63, respectively. The SBQ-R's correlation with SA and LSI confirmed its concurrent validity. Regression analysis confirmed the ability of both cut-off points to distinguish the participants with high SA and LSI; however, the cut-off point ≥ 8 produced better results regarding high LSI. Based on item 1, normal versus low- and high-risk samples were significantly different in terms of SA, LSI, and adjusted total score of SBQ-R (P < 0.0001). CONCLUSION SBQ-R is an economic and psychometrically sound tool, which can be utilized to identify suicide-related behaviors and risks in young Iranian population.
Collapse
Affiliation(s)
- Mohammadali Amini-Tehrani
- Department of Psychology and Education, University of Tehran, Tehran, Iran; Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Nasiri
- Department of Psychology and Education, University of Tehran, Tehran, Iran
| | - Tina Jalali
- Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Raheleh Sadeghi
- Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amene Ghotbi
- Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Zamanian
- Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Qom University of Medical Sciences, Qom, Iran.
| |
Collapse
|
209
|
Hunt QA, Morrow QJ, McGuire JK. Experiences of Suicide in Transgender Youth: A Qualitative, Community-Based Study. Arch Suicide Res 2020; 24:S340-S355. [PMID: 31062669 DOI: 10.1080/13811118.2019.1610677] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The aim was to develop understanding around the experience of suicide in transgender youth. Method: Qualitative analysis with 85 interviews with transgender youth about their histories with suicidality was performed. Participants were recruited from community clinics in three counties (United States, Canada, and Ireland) between 2010 and 2014. Results: Factors that precipitated participants' suicide attempts included rejection based on gender identity and gender dysphoria. Participants demonstrated resilience by attempting to connect with loved ones for support and through self-awareness of mental states, including by regulating behaviors they perceived to adversely affect their mental health. Conclusions: Transgender youth may fear seeking health care due to health professionals' lack of understanding of transgender issues and fear of further victimization. Reframing suicidality as a rational decision-making process in response to stress may further understanding of why people attempt suicide and provide new avenues for intervention.
Collapse
|
210
|
Berardelli I, Forte A, Innamorati M, Imbastaro B, Montalbani B, Sarubbi S, De Luca GP, Mastrangelo M, Anibaldi G, Rogante E, Lester D, Erbuto D, Serafini G, Amore M, Pompili M. Clinical Differences Between Single and Multiple Suicide Attempters, Suicide Ideators, and Non-suicidal Inpatients. Front Psychiatry 2020; 11:605140. [PMID: 33384631 PMCID: PMC7769945 DOI: 10.3389/fpsyt.2020.605140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/18/2020] [Indexed: 12/23/2022] Open
Abstract
Single suicide attempters (SSAs) and multiple suicide attempters (MSAs) represent distinct subgroups of individuals with specific risk factors and clinical characteristics. This retrospective study on a sample of 397 adult psychiatric inpatients analyzed the main sociodemographic and clinical differences between SSAs and MSAs and the possible differences between SSAs, MSAs, and psychiatric patients with and without suicidal ideation (SI). Clinical variables collected included psychiatric diagnoses (Mini International Neuropsychiatric Interview), presence of substance use, current suicide risk status (Columbia Suicide Severity Rating Scale), Clinical Global Impression at admission, Global Assessment of Functioning improvement between admission and discharge, age at onset of psychiatric illness, duration of untreated illness in years, number of hospitalizations in psychiatric settings, and lethality of the most severe suicide attempt. A multinomial logistic regression model with groups showed that MSAs had a higher lethality of their last suicide attempt as compared to SSAs. In addition, MSAs had distinct sociodemographic characteristics compared to both SSAs and patients with SI. Although the study was limited by the relatively small sample size and retrospective nature, the present results suggest that identifying MSAs could be useful in predicting suicide risk and designing ad hoc prevention strategies.
Collapse
Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alberto Forte
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetta Imbastaro
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Benedetta Montalbani
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Gabriele Pasquale De Luca
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Martina Mastrangelo
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gaia Anibaldi
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ, United States
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
211
|
Bickford D, Morin RT, Nelson JC, Mackin RS. Determinants of Suicide-related Ideation in Late Life Depression: Associations with Perceived Stress. Clin Gerontol 2020; 43:37-45. [PMID: 31514586 PMCID: PMC6923534 DOI: 10.1080/07317115.2019.1666442] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: Perceived stress is emerging as a potential contributing factor in suicide-related ideation in older adults. We hypothesized higher levels of perceived stress would be associated with increased self-reported suicidal ideation independent of depressive symptom severity.Methods: This study used data from community-dwelling older adults aged ≥65 with a current diagnosis of major depression. Eligible participants completed measures of depression symptom severity (Hamilton Depression Rating Scale-17 item), current suicidal ideation (Geriatric Suicide Ideation Scale), and perceived stress (Perceived Stress Scale).Results: Participants were 225 older adults with a mean age of 71.4 (SD = 5.6). Sixty-five percent of the sample was female. Fifteen percent of the variance in suicidal ideation was accounted for by lower education (p = .03), male sex (p = .03) and higher current perceived stress (p < .001). Specifically, stress accounted for 12% of the variance.Conclusions: Perceived stress is an important avenue to increase identification of individuals with a higher risk of suicide-related ideation among older adults with a current diagnosis of major depression.Clinical Implications: Screening for perceived stress may allow for improved screening and prevention of suicidal activity in depressed older adults.
Collapse
Affiliation(s)
- David Bickford
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Ruth T Morin
- Department of Psychiatry, University of California, San Francisco, California, USA.,Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA
| | - James Craig Nelson
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Robert Scott Mackin
- Department of Psychiatry, University of California, San Francisco, California, USA.,Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA
| |
Collapse
|
212
|
Grendas LN, Rojas SM, Rodante DE, Puppo S, Vidjen P, Portela A, Daray FM. Differential Impact of Child Sexual Abuse and Family History of Suicidal Behavior in High-Risk Suicidal Patients. Arch Suicide Res 2020; 24:S251-S263. [PMID: 30955484 DOI: 10.1080/13811118.2019.1592040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The current study aimed to compare suicide-related variables as a function of 1) family history of suicidal behavior and 2) child sexual abuse among patients hospitalized for a suicide attempt or active suicidal ideation. Family history of suicidal behavior and child sexual abuse were examined independently and in combination as a diathesis for a high-risk suicidal phenotype. A multicenter cross-sectional study was designed to compare data obtained from 292 patients hospitalized for suicidal behavior. Demographic and clinical variables were compared among Group 1 (patients who reported both family history of suicidal behavior and child sexual abuse), Group 2 (patients who reported only family history of suicidal behavior), Group 3 (patients who reported only child sexual abuse), and Group 4 (patients who did not report family history of suicidal behavior or childhood sexual abuse). A multinomial logistic regression was used to examine suicide-related variables associated with each group and to compare differences between groups. Group 1 and 3 endorsed a higher number of previous suicide attempts and were more likely to be younger at the first suicide attempt compared to Group 4. Group differences remained after adjustment in a multinomial regression model. The current findings suggest that child sexual abuse may be more strongly related to suicide risk among high risk patients than family history of suicidal behavior.
Collapse
Affiliation(s)
- Leandro N Grendas
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Teodoro Álvarez" General Hospital. Dr. Juan Felipe Aranguren 2701, Buenos Aires, Argentina
| | - Sasha M Rojas
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Demián E Rodante
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Soledad Puppo
- "José de San Martín" Hospital, Buenos Aires, Argentina
| | | | | | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,"Dr. Braulio A. Moyano" Neuropsychiatric Hospital, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| |
Collapse
|
213
|
Fountoulakis KN. Suicides in Greece before and during the period of austerity by sex and age group: Relationship to unemployment and economic variables. J Affect Disord 2020; 260:174-182. [PMID: 31494368 DOI: 10.1016/j.jad.2019.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/04/2019] [Accepted: 09/01/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND There is disagreement on the specific mechanism through which the economic recession increased suicides in Greece. Unemployment is considered by many authors to be the determining factor but the data are inconclusive and often negative, especially concerning the temporal relationship between onset of increase in unemployment and increase in suicides AIMS: The aim of this paper was to clarify the specific role of unemployment as well as of other socioeconomic variables on specific age-by-gender groups concerning the increase in suicides. METHODS Data of the Hellenic Statistical Authority ELSTAT (www. STATISTICS gr) were analyzed with Linear Regression Analysis and Bonferroni correction for multiple testing RESULTS: Unemployment correlates with suicide rates only in males aged 20-24, 50-54 and 60-64 years (p < 0.001). Unemployment could held responsible for an additional 148 male deaths during the period 2009-2015, which accounts for 5.3% of the total (29 additional deaths per year). The changes in all the socioeconomic conditions could held responsible for 317 cases of suicide or 9.4% of total CONCLUSIONS: The results of the current study suggest that there was a 33% increase in deaths by suicide in Greece during the early years of recession (2009-2015); one third could be directly attributed to unemployment, one third to other consequences of recession while another third is of unknown origin. The effect of unemployment is specifically restricted to males at the beginning of their working career (20-24 years old) and to middle aged (45-49 and 55-59 years old).
Collapse
Affiliation(s)
- Konstantinos N Fountoulakis
- Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos str, 55535 Thessaloniki, Greece.
| |
Collapse
|
214
|
Rogers ML, Hom MA, Dougherty SP, Gallyer AJ, Joiner TE. Comparing Suicide Risk Factors Among Individuals with a History of Aborted, Interrupted, and Actual Suicide Attempts. Arch Suicide Res 2020; 24:57-74. [PMID: 30303461 DOI: 10.1080/13811118.2018.1522283] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Recent standardized nomenclature has suggested distinctions among aborted, interrupted, and actual suicide attempts. This study examined differences in self-reported symptoms among individuals with a history of aborted, interrupted, and actual suicide attempts. 167 young adults with a history of suicidality completed self-report measures of suicide attempt history and current symptoms, a clinical interview assessing past suicidal behavior, and a pain tolerance task. Only 78.8% of participants who initially reported a suicide attempt history were classified as suicide attempters following the clinical interview. Individuals who reported only aborted attempts during the clinical interview reported less severe clinical symptoms than those reporting a history of at least one actual attempt. Individuals with a history of actual suicide attempts may represent a more clinically severe group than those with a history of aborted attempts only.
Collapse
|
215
|
Levine D, Horesh D. Suicidality in Fibromyalgia: A Systematic Review of the Literature. Front Psychiatry 2020; 11:535368. [PMID: 33173505 PMCID: PMC7538832 DOI: 10.3389/fpsyt.2020.535368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/27/2020] [Indexed: 11/13/2022] Open
Abstract
Fibromyalgia (FM), a poorly understood rheumatic condition, is characterized by chronic pain and psychiatric comorbidities, most notably depression and anxiety. Additional symptoms include sleep difficulties, fatigue, and various cognitive impairments. Furthermore, FM is surrounded by social stigma, due to the unclear nature and etiology of this condition. While there is widespread evidence for the emotional and psychological suffering of those with FM, the scope of suicidality, as well as the underlying factors that are associated with suicidal ideation and behavior among this population, are not well understood. The present review, which is the first of its kind, aims to summarize existing data on the prevalence of suicide-related outcomes among FM patients, highlight factors associated with suicidal ideation and behavior in FM, and identify gaps in the literature to better inform research and clinical care. Studies were extracted from the literature that measured suicidal ideation, attempted suicide, and/or completed suicide among FM patients. Results indicated that both suicidal ideation and suicidal behavior were prevalent among individuals suffering from FM. Psychiatric comorbidity, sleep difficulties, and inpatient hospitalization were associated with both suicidal ideation and suicidal behavior. Functional impairment was associated with suicidal ideation in FM. Factors associated with higher levels of suicidal behavior in FM included female gender, unemployment and lower income, medical comorbidity, and drug dependence. While an understanding of currently recognized risk factors is important for improving FM research and clinical care, some clear methodological and conceptual limitations of the reviewed studies were identified. Future work should focus on longitudinal studies, as well as on gaining a better biological and psychological understanding of the underpinnings of FM and suicidality.
Collapse
Affiliation(s)
- Daniella Levine
- Department of Psychology, New York University, New York, NY, United States.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.,Department of Psychiatry, New York University Langone Medical Center, New York, NY, United States
| |
Collapse
|
216
|
Di Nicola M, Mazza M, Panaccione I, Moccia L, Giuseppin G, Marano G, Grandinetti P, Camardese G, De Berardis D, Pompili M, Janiri L. Sensitivity to Climate and Weather Changes in Euthymic Bipolar Subjects: Association With Suicide Attempts. Front Psychiatry 2020; 11:95. [PMID: 32194448 PMCID: PMC7066072 DOI: 10.3389/fpsyt.2020.00095] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/05/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Climate and weather are known to affect multiple areas of human life, including mental health. In bipolar disorder (BD), seasonality represents an environmental trigger for mood switches, and climatic variables may contribute to recurrences. Several studies reported seasonal and climatic-related variations in the rate of suicide attempts. Suicide risk is relevant in BD, with approximately 25% of patients attempting suicide. Therefore, this study aimed to assess sensitivity to weather and climatic variations in BD subjects and its relationship with lifetime suicide attempts. METHODS Three hundred fifty-two euthymic BD and 352 healthy control subjects, homogeneous with respect to socio-demographic characteristics, were enrolled. All participants were administered the METEO-Questionnaire (METEO-Q) to evaluate susceptibility to weather and climatic changes. We also investigated the potential relationship between sensitivity to climate and weather and lifetime suicide attempts in BD patients. RESULTS METEO-Q scores and the number of subjects reaching the cut-off for meteorosensitivity/meteoropathy were significantly higher in BD patients. Within the clinical group, BD subjects with lifetime suicide attempts obtained higher METEO-Q scores, with no differences between BD-I and BD-II. The number of suicide attempts directly correlated with METEO-Q scores. The presence of suicide attempts was associated with the physical and psychological symptoms related to weather variations. DISCUSSION Our findings support the relevance of sensitivity to weather and climate variations in a large sample of BD subjects and point out the association of this feature with lifetime suicide attempts.
Collapse
Affiliation(s)
- Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianna Mazza
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Giuseppin
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Marano
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Giovanni Camardese
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
| | - Maurizio Pompili
- Suicide Prevention Centre, Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
217
|
Conner A, Azrael D, Miller M. Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study. Ann Intern Med 2019; 171:885-895. [PMID: 31791066 DOI: 10.7326/m19-1324] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The suicide case-fatality rate (CFR)-the proportion of suicidal acts that are fatal-depends on the distribution of methods used in suicidal acts and the probability of death given a particular method (method-specific CFR). OBJECTIVE To estimate overall and method-specific suicide CFRs and the distribution of methods used in suicidal acts by demographic characteristics. DESIGN Cross-sectional study. SETTING United States, 2007 to 2014. PARTICIPANTS Suicide deaths (n = 309 377 records from the National Vital Statistics System) and nonfatal suicide attempts requiring treatment in an emergency department (ED) (n = 1 791 638 records from the Nationwide Emergency Department Sample) or hospitalization (n = 1 556 871 records from the National [Nationwide] Inpatient Sample) among persons aged 5 years or older. MEASUREMENTS Rates of suicide deaths and nonfatal suicide attempts, overall and method-specific CFRs, and distribution of methods used, by sex, age group, region, and urbanization. RESULTS Overall, 8.5% of suicidal acts were fatal (14.7% for males vs. 3.3% for females; 3.4% for persons aged 15 to 24 years vs. 35.4% for those aged ≥65 years). Drug poisoning accounted for 59.4% of acts but only 13.5% of deaths; firearms and hanging accounted for only 8.8% of acts but 75.3% of deaths. Firearms were the most lethal method (89.6% of suicidal acts with a firearm resulted in death), followed by drowning (56.4%) and hanging (52.7%). Method-specific CFRs were higher for males and older persons. The distribution of methods varied across demographic groups. LIMITATIONS Results are based on suicidal acts resulting in an ED visit, a hospitalization, or death. Consequently, the reported CFRs are larger than they would have been had the data included nonfatal attempts that did not result in an ED visit. CONCLUSION Variation in overall suicide CFR between sexes and across age groups, regions, and urbanization is largely explained by the distribution of methods used in suicidal acts. PRIMARY FUNDING SOURCE Joyce Foundation.
Collapse
Affiliation(s)
- Andrew Conner
- Quinnipiac University, North Haven, Connecticut (A.C.)
| | - Deborah Azrael
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts (D.A.)
| | - Matthew Miller
- Harvard T.H. Chan School of Public Health and Northeastern University, Boston, Massachusetts (M.M.)
| |
Collapse
|
218
|
Pelizza L, Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, Pupo S, Raballo A. Suicidal Thinking and Behavior in Adolescents at Ultra-High Risk of Psychosis: A Two-year Longitudinal Study. Suicide Life Threat Behav 2019; 49:1637-1652. [PMID: 30932235 DOI: 10.1111/sltb.12549] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 01/14/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Suicide risk in subjects at Ultra-High Risk of psychosis (UHR) has been rarely assessed in adolescence, but it is of obvious importance for prognostic and clinical care reasons. In this study, we aimed to prospectively assess suicide risk and behaviors in UHR adolescents. METHOD We examined 112 help-seeking adolescents (13-18 years, 50% males, 83.9% Caucasian) that were enrolled in the Reggio Emilia At-Risk Mental States (ReARMS) project and followed up for 2 years. Specific items derived from the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Beck Depression Inventory-II (BDI-II) were used to assess suicide risk. Suicide attempts and completed suicides were also recorded. RESULTS Baseline assessment detected 40 UHR adolescents, 32 FEP (first-episode psychosis), and 40 non-UHR/FEP. We found that 67.5% of UHR adolescents had suicidal ideation, and 18.5% to severe degree. Attempted suicide before enrollment was higher in the UHR group than in non-UHR/FEP peers (17.5% vs. 2.5%). BDI-II suicidal ideation severity was stable at 12-month follow-up and decreased at 24-month follow-up. CONCLUSIONS A high prevalence of suicidal ideation among UHR adolescents was found and supports the routine monitoring of risk of self-injurious thinking and behavior in this at-risk population.
Collapse
Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Rocco Chiri
- Department of Mental Health and Pathological Addiction, Azienda USL di Bologna, Bologna, Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Raballo
- Psychodiagnostic and Clinical Psychopharmacology Unit, Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy
| |
Collapse
|
219
|
Gauthier JM, Cole AB, Bagge CL. A preliminary examination of the association between drinking as a typical coping strategy and level of acute alcohol consumption prior to a suicide attempt. Psychiatry Res 2019; 282:112626. [PMID: 31685287 PMCID: PMC6923992 DOI: 10.1016/j.psychres.2019.112626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 01/02/2023]
Abstract
Drinking to cope is associated with suicide ideation and attempts. Event-based research shows drinking, particularly when alcohol is consumed in large quantities, increases the intensity of suicidal thoughts and immediate risk for attempt. Such findings suggest those who typically drink to cope may be especially likely to drink heavily in the hours preceding a suicide attempt. In the first examination of the association between regular use of alcohol as a coping strategy and acute alcohol consumption prior to a suicide attempt, participants included 130 patients hospitalized for a recent attempt. The number of drinks consumed in the acute period preceding the attempt, as well as past-year heavy drinking frequency, typical drinking motives, and depressive symptoms were assessed. The unique impacts of coping motives on odds of consuming any alcohol, and of using specific amounts of alcohol in the acute period, were determined through binary and multinomial logistic regressions. Results demonstrated that commonly drinking for coping motives increased the odds of heavy drinking - but not of using alcohol at low levels - during the acute period. Results held after adjusting for relevant covariates. Clinicians should assess drinking motives and prioritize prevention of drinking to cope to reduce risk of alcohol-related suicide attempts.
Collapse
Affiliation(s)
- Jami M Gauthier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Substance Abuse Treatment Program, Atlanta VA Medical Center, Atlanta, GA, United States.
| | - Ashley B Cole
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, United States; Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, MI, United States
| |
Collapse
|
220
|
Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, Tan W, Ho CS, Ho RC. Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4581. [PMID: 31752375 PMCID: PMC6888476 DOI: 10.3390/ijerph16224581] [Citation(s) in RCA: 218] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/03/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. METHODS A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.
Collapse
Affiliation(s)
- Kim-San Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
| | - Celine H. Wong
- Division of Child and Adolescent Psychiatry, Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON M5T 1R8, Canada;
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Jiayun Wang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
| | - Zhisong Zhang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
| | - Bach X. Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Vietnam Young Physicians’ Association, Hanoi 100000, Vietnam
| | - Wanqiu Tan
- The China-Singapore (Chongqing) Demonstration Initiative on Strategic Connectivity Think Tank, Chongqing 400043, China;
| | - Cyrus S. Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger C. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
- Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119228, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
| |
Collapse
|
221
|
Mejías-Martín Y, Luna del Castillo JDD, Rodríguez-Mejías C, Martí-García C, Valencia-Quintero JP, García-Caro MP. Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4496. [PMID: 31739626 PMCID: PMC6888127 DOI: 10.3390/ijerph16224496] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 12/16/2022]
Abstract
Discrepant results have been published by studies comparing deaths by suicide with attempted suicides. This study aimed to determine factors associated with suicides and attempted suicides in Andalusia (Spain) between 2007 and 2013, comparing sex, age, year, and suicide method between these populations. A retrospective study was conducted of data on deaths by suicide and attempted suicides over a seven-year period, calculating the sex and age rates for each behavior. Adjusted Poisson regression was used to analyze the association with study variables, and incidence rate ratios were estimated. During the seven-year study period, 20,254 attempted suicides and 5202 deaths by suicide were recorded. The prevalence of attempted suicide did not differ between the sexes, whereas the prevalence of deaths by suicide was three-fold higher among males than among females and increased with higher age. The most frequently used method was the same in males and females for suicide attempts, but differed between the sexes for suicides. The combined influence of sex and age was greater in the model for death by suicide than in the model for attempted suicide. The key differentiating factor was the method used, while the finding of greatest concern was the suicide behavior among the elderly. Preventive strategies should take these differences into account.
Collapse
Affiliation(s)
- Yolanda Mejías-Martín
- Department of Mental Health, General University Hospital Virgen de las Nieves, 18014 Granada, Spain;
| | | | - Candela Rodríguez-Mejías
- Department of Intensive Care, General University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.R.-M.); (J.P.V.-Q.)
| | - Celia Martí-García
- Department of Nursing, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | - Juan Pablo Valencia-Quintero
- Department of Intensive Care, General University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.R.-M.); (J.P.V.-Q.)
| | - María Paz García-Caro
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain;
| |
Collapse
|
222
|
Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of Suicidal Behaviors Among High School Students in the United States: 1991-2017. Pediatrics 2019; 144:peds.2019-1187. [PMID: 31611338 PMCID: PMC7299440 DOI: 10.1542/peds.2019-1187] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if racial and ethnic subgroups of adolescents are at high risk for engagement in suicidal behaviors. METHODS Using the nationally representative school-based Youth Risk Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses to examine trends by different racial and ethnic groups, with each suicide indicator serving as a dichotomous outcome. Participants included 198 540 high school students. RESULTS Across all sex and race and ethnic groups, there were significant linear decreases in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents (odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time. Black adolescents had positive linear trends for suicide attempts among both boys (OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR, 1.04; P = .048) had a significant linear increase in injury by attempt. CONCLUSIONS The results suggest that, over time, black youth have experienced an increase in suicide attempts, which is troubling because attempts are the most prominent risk factor associated with suicide death. For black boys, a significant increase in injury by attempt occurred, which suggests that black boys may be engaging in increasingly lethal means when attempting suicide. Examining trends of suicidal thoughts and behaviors over time by sex and race and ethnicity allow us to determine where to focus prevention and intervention efforts. Future research should examine the underlying reasons for these changes observed in US high school students.
Collapse
Affiliation(s)
- Michael A. Lindsey
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Arielle H. Sheftall
- Center for Suicide Prevention and Research, Nationwide Children’s Hospital, Columbus, Ohio;,Center for Innovation in Pediatric Practice, Nationwide Children’s Hospital, Columbus, Ohio;,The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio;,Department of Pediatrics, College of Medicine, Ohio State University, Columbus, Ohio
| | - Yunyu Xiao
- McSilver Institute for Poverty Policy and Research, New York University, New York, New York;,Silver School of Social Work, New York University, New York, New York
| | - Sean Joe
- George Warren Brown School of Social Work, Washington University in St Louis, St Louis, Missouri
| |
Collapse
|
223
|
Risk factors for suicide attempt: A population-based -genetic study from Telangana, India. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00446-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
224
|
Yang L, Liu X, Chen W, Li L. A Test of the Three-Step Theory of Suicide among Chinese People: A Study Based on the Ideation-to-Action Framework. Arch Suicide Res 2019; 23:648-661. [PMID: 30024342 DOI: 10.1080/13811118.2018.1497563] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this study was to test the Three-Step Theory (3ST) of suicide in a sample of college students in China (N = 1,097). All participants completed a battery of questionnaires indexing psychological pain, hopelessness, connectedness, suicide capacity, suicide ideation, and suicide attempt. The prevalence of suicide ideation and suicide attempt among the sample were 21.42% and 3.83%, respectively. The hierarchical regression analysis showed that psychological pain and hopelessness interacted to predict suicide ideation, and that connectedness was the most protective against ideation in those high on both pain and hopelessness. Suicide capacity differentiated attempters from ideators above and beyond current suicide ideation. These findings provide preliminary evidence for the validity of 3ST of suicide within Chinese contexts. Implications for suicide prevention and intervention and future research directions are also discussed.
Collapse
Affiliation(s)
| | | | - Wei Chen
- Tianjin Academy of Fine Arts , China
| | | |
Collapse
|
225
|
Abstract
Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.
Collapse
|
226
|
Cole AB, Littlefield AK, Gauthier JM, Bagge CL. Impulsivity facets and perceived likelihood of future suicide attempt among patients who recently attempted suicide. J Affect Disord 2019; 257:195-199. [PMID: 31301623 DOI: 10.1016/j.jad.2019.07.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 06/12/2019] [Accepted: 07/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Given the substantial heterogeneity of both impulsivity and suicidality, increased specificity in studying relations between these variables is needed. One aspect of suicidality that may be especially important for predicting future risk among those with a recent suicide attempt is self-perceived likelihood of making a future attempt (suicide likelihood). Presently, little is known about the extent to which impulsivity is related to this important aspect of suicidality. We examined whether three distinct impulsivity facets (i.e., deficits in conscientiousness, negative urgency, and sensation seeking) would differentially predict suicide likelihood. METHODS Participants included 155 psychiatric inpatients who presented to a Level-1 trauma hospital after a recent suicide attempt. Structural Equation Modeling (SEM), in which demographic and clinical covariates were controlled, was conducted to examine whether each impulsivity facet would uniquely predict suicide likelihood. RESULTS Deficits in conscientiousness was the only robust predictor of suicide likelihood, with an association that persisted after accounting for demographic and clinical covariates. LIMITATIONS The cross-sectional design and unknown predictive validity of suicide likelihood are study limitations. CONCLUSION This was a preliminary investigation of impulsivity facets with suicide likelihood. Clinical implications of this study suggest that deficits in conscientiousness and suicide likelihood may be important factors to consider when identifying and intervening with patients at high-risk for suicide.
Collapse
Affiliation(s)
- Ashley B Cole
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA; Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA.
| | | | - Jami M Gauthier
- Substance Abuse Treatment Program, Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA; Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
227
|
Kattimani S, Sarkar S, Menon V, Muthuramalingam A, Nancy P. Duration of suicide process among suicide attempters and characteristics of those providing window of opportunity for intervention. J Neurosci Rural Pract 2019; 7:566-570. [PMID: 27695238 PMCID: PMC5006470 DOI: 10.4103/0976-3147.185505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: There is limited cross-cultural literature on the duration of suicide process among attempters. Aims: The primary aim was to assess the duration of suicide process among suicide attempters attending the Crisis Intervention Clinic. We also aimed to identify the characteristics of those who reported a longer duration for this process. Methods: In this retrospective record-based study, we collected the duration of the suicidal process from the records of all the suicide attempters evaluated over a 3-year period (n = 319). Attempters were divided into four groups based on the quartile value of the duration of the suicidal process. For analysis, the characteristics of those in the last quartile with suicide process time of >120 min (n = 75) were compared with those in the first three (n = 244). Those in the last quartile were considered to provide a window of opportunity for intervention. Results: The median time for the suicidal process was 30 min (interquartile range of 5 min to 120 min). Seventy-five (23.5%) subjects belonged to the fourth quartile (duration of suicide process >120 min). A significant proportion of them came from urban areas (P = 0.011), had a diagnosis of mood disorder (P = 0.028), had visited a health professional in the recent past (P = 0.015), and had lower rates of attempt under intoxication (P = 0.005). A lesser proportion of them showed problem-focused disengagement style of coping strategy (P = 0.015). Conclusions: The suicide process time among Indian suicide attempters is short. However, a quarter of them has suicide process duration of 2 h which provides some scope for intervention. Individual and community level interventions need further evaluation for their potential efficacy in preventing the progress of the suicidal process.
Collapse
Affiliation(s)
- Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Avin Muthuramalingam
- Department of Psychiatry, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Puducherry, India
| | - Premkumar Nancy
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
228
|
Ayesa-Arriola R, Canal Rivero M, Delgado-Alvarado M, Setién-Suero E, González-Gómez J, Labad J, David AS, Crespo-Facorro B. Low-density lipoprotein cholesterol and suicidal behaviour in a large sample of first-episode psychosis patients. World J Biol Psychiatry 2019; 19:S158-S161. [PMID: 29235890 DOI: 10.1080/15622975.2017.1414305] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Our aims were to confirm the relationship between lipid and lipoprotein concentrations and suicidal behaviour in first-episode psychosis (FEP) patients. METHODS Suicidal behaviour was explored in a large FEP sample (N = 383). Baseline lipid profile was compared between those who attempted or completed suicide and those who not presented suicidal behaviour. RESULTS Low-density lipoprotein cholesterol (LDL-c) (OR = 0.99, 95% CI= 0.98-1.00) and depressive symptoms (OR = 1.15, 95% CI = 1.06-1.24) were significantly related with suicidal behaviour. CONCLUSIONS Lipid profile test may be considered in the assessment of suicide risk in psychosis and LDL-c an important biological marker.
Collapse
Affiliation(s)
- Rosa Ayesa-Arriola
- a Department of Psychiatry , Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria , Santander , Spain.,b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain
| | - Manuel Canal Rivero
- a Department of Psychiatry , Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria , Santander , Spain.,b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain
| | - Manuel Delgado-Alvarado
- b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain.,c Neurology Department, Neuroimaging Unit , Marqués de Valdecilla University Hospital. Valdecilla Biomedical Research Institute, IDIVAL , Santander , Spain
| | - Esther Setién-Suero
- a Department of Psychiatry , Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria , Santander , Spain.,b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain
| | - Jana González-Gómez
- a Department of Psychiatry , Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria , Santander , Spain
| | - Javier Labad
- b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain.,d Department of Psychiatry , Corporació Sanitària Universitaria Parc Taulí, I3PT, UAB , Sabadell , Spain
| | - Anthony S David
- e Department of Psychosis Studies. Institute of Psychiatry , King's College London , London , UK
| | - Benedicto Crespo-Facorro
- a Department of Psychiatry , Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria , Santander , Spain.,b CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Spain
| |
Collapse
|
229
|
Goodfellow B, Kõlves K, De Leo D. Contemporary Classifications of Suicidal Behaviors. CRISIS 2019; 41:179-186. [PMID: 31512927 DOI: 10.1027/0227-5910/a000622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The absence of agreed-upon terminology, definitions, and operational classifications has hampered research in the field of suicidology for many decades. Aims and Method: We systematically reviewed contemporary classifications of suicidal behavior using the scope of the classification (comprehensive vs. restricted or single behaviors), and the presence or absence of a classification scheme and an operational definition of intent as features to enable analysis and comparison. Results: A chronological perspective shows that classification systems tend to be more and more precise and operational for clinical and research field work. However, on an international level, the development of classifications appears to precede the establishment of agreed-upon definitions and terms to describe suicidal behavior. Limitations: The review was conducted in English only. Conclusion: Universal agreement on definitions and terms for suicidal behavior should precede the development of classifications.
Collapse
Affiliation(s)
- Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia.,Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
| | - Diego De Leo
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
| |
Collapse
|
230
|
Personality traits, theory of mind and their relationship with multiple suicide attempts in a sample of first episode psychosis patients: One-year follow-up study. J Affect Disord 2019; 256:176-182. [PMID: 31177045 DOI: 10.1016/j.jad.2019.05.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/12/2019] [Accepted: 05/31/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND High rates of suicidal behaviour (SB) have been found in first episode psychosis (FEP) patients. It has been suggested that the presence of multiple suicide attempts (mSA) increases the risk of later SA and the risk of eventual death by suicide. OBJECTIVE Our main objective was to study the baseline factors associated with the presence of mSA during the first year after FEP. In addition, a second aim was to find out whether there were any differences between single and multiple suicide attempters in the timing of the first SA after FEP. METHOD A total of 65 FEP patients were evaluated. The presence of SAs were recorded at two different times after FEP. Bivariate and multivariate analyses were performed to explore the relationship between SA with sociodemographic and clinical variables. RESULTS Multiple linear regression showed that mSA was associated with the presence of increased symptom severity (B = 0.35; t = 3.67; p < 0.01) and errors in first-order false-belief task (B = 0.48; t = 2.11; p = 0.04). There were significant differences in the timing of first SA after FEP between multiple and single suicide attempters. CONCLUSIONS Theory of mind impairments along with more severe symptoms during the first contact with mental health services for psychotic symptoms appeared to be important predictors of mSA. On the other hand, multiple suicide attempters tend to make a first SA after FEP earlier than single suicide attempters. These results could contribute to the implementation of preventive suicidal programs, however they must be confirmed by additional research.
Collapse
|
231
|
Costa-Maia I, Marina S, Ricou M. Wish to Die: Suicide and Its Link to Euthanasia. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:927-943. [DOI: 10.1177/0030222819871182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article analyzes suicidal behavior and how its inherent processes of death ideation can overlap with those seeking euthanasia. We present a literature review of three main events in suicide (suicidal ideation, suicide attempt, and suicide) in different populations and evaluate implications for health-care practice and risk assessment taking into account the context of euthanasia. We ponder upon the motives behind suicide and its link with wish to die requests to hasten death. We discuss the possibility of the reversal of a wish to die as well as a potential process of differentiating between individuals who would maintain their wish and benefit from termination of life and others who would later change their minds.
Collapse
Affiliation(s)
| | - Sílvia Marina
- Faculty of Medicine, CINTESIS - Center for Health Technology and Services Research, Porto University, Portugal
| | - Miguel Ricou
- Faculty of Medicine, CINTESIS - Center for Health Technology and Services Research, Porto University, Portugal
| |
Collapse
|
232
|
Necho M, Mekonnen S, Haile K, Birkie M, Belete A. Suicidal plan, attempt, and associated factors among patients with diabetes in Felegehiwot referral hospital, Bahirdar, Ethiopia: cross-sectional study. BMC Psychiatry 2019; 19:258. [PMID: 31455263 PMCID: PMC6712698 DOI: 10.1186/s12888-019-2253-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetes is a highly prevalent non-communicable disease which is prone to more psychiatric complications like suicide; however, research into this area is limited. Assessing suicidal plan and attempt as well as its determinants are therefore important. METHOD Institution based cross-sectional study was conducted from May 21 to June 21 at the diabetic outpatient clinic by recruiting 421 participants using systematic sampling. Suicide manual of the composite international diagnostic interview (CIDI) was used to assess suicidal plan and attempt. Chart review was used to obtain data regarding the co-morbidity of medical illness and complications of diabetes mellitus. Binary logistic regression was used to identify factors associated with suicidal attempt. Odds ratio with 95% CI was employed and variables with a p-value of< 0.05 in multivariable logistic regression were declared significant. RESULTS From 423 participants 421 participated in the study with 99.5% response rate. The mean age (±SD) of the respondents was 38.0((±13.9) years. The lifetime prevalence of Suicidal plan; an attempt was found to be 10.7 and 7.6% respectively. Being female (AOR = 2.14, 95%CI:1.10,5.65), poor social support (AOR = 3.21,95%CI:1.26,8.98), comorbid depression (AOR = 6.40,95%CI:2.56,15.46) and poor glycemic control (AOR = 4.38,95%CI:1.66,9.59) were factors associated with lifetime suicidal attempt. CONCLUSION The prevalence of suicidal attempt among Diabetes patients is high (7.6%). The suicidal attempt had a statistically significant association with female gender, comorbidity with depression, poor social support and poor glycemic control. Therefore the result of this study helps to do early screening, treatment, and referral of patients with suicidal attempt.
Collapse
Affiliation(s)
- Mogesie Necho
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
| | - Solomon Mekonnen
- 0000 0000 8539 4635grid.59547.3aDepartment of Public Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Kelemua Haile
- AmanuelMentalSpecialized Hospital, Addis Ababa, Ethiopia
| | - Mengesha Birkie
- 0000 0004 0515 5212grid.467130.7Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Asmare Belete
- 0000 0004 0515 5212grid.467130.7Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| |
Collapse
|
233
|
Septier M, Stordeur C, Zhang J, Delorme R, Cortese S. Association between suicidal spectrum behaviors and Attention-Deficit/Hyperactivity Disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 103:109-118. [DOI: 10.1016/j.neubiorev.2019.05.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 01/27/2023]
|
234
|
Rodante DE, Grendas LN, Puppo S, Vidjen P, Portela A, Rojas SM, Chiapella LC, Daray FM. Predictors of short- and long-term recurrence of suicidal behavior in borderline personality disorder. Acta Psychiatr Scand 2019; 140:158-168. [PMID: 31155713 DOI: 10.1111/acps.13058] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/23/2019] [Accepted: 05/28/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the incidence of suicidal outcomes and risk factors for short- and long-term recurrence of suicidal behavior (SB) among high-risk borderline personality disorder (BPD) patients during a 24-month prospective follow-up period. METHODS A multicenter prospective cohort study was designed to compare data obtained from 136 patients admitted to the emergency department for current suicidal ideation (SI) or a recent suicide attempt (SA). Subjects were clinically evaluated and monitored for a new SA or suicide. RESULTS The incidence of a new SA was 25.63 events/100 persons-year, and one patient died by suicide. Child sexual abuse (CSA) was the only significant predictor throughout the complete follow-up period. The absence of prior psychiatric treatment predicts the recurrence of SB in the first 6 months of follow-up. Patient age, poor psychosocial functioning before hospitalization, age at first SA, and having multiple suicide attempts increased risk of SB recurrence at the long-term period (24th months). In addition, there was an interaction between CSA and poor psychosocial functioning that increased risk of SB. CONCLUSION The risk of recurrence was higher during the first 6 months. Risk factors at 6 and 24 months vary. These findings are important for implementing suicide strategies.
Collapse
Affiliation(s)
- D E Rodante
- School of Medicine, Institute of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.,Braulio A. Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - L N Grendas
- School of Medicine, Institute of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.,Teodoro Alvarez Hospital, Buenos Aires, Argentina
| | - S Puppo
- School of Medicine, Institute of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.,Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - P Vidjen
- José Tiburcio Borda Hospital, Buenos Aires, Argentina
| | - A Portela
- José Tiburcio Borda Hospital, Buenos Aires, Argentina
| | - S M Rojas
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - L C Chiapella
- Pharmacology Area, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Rosario, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - F M Daray
- School of Medicine, Institute of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| |
Collapse
|
235
|
Drapeau CW, Nadorff MR, McCall WV, Titus CE, Barclay N, Payne A. Screening for suicide risk in adult sleep patients. Sleep Med Rev 2019; 46:17-26. [DOI: 10.1016/j.smrv.2019.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/07/2019] [Accepted: 03/22/2019] [Indexed: 01/10/2023]
|
236
|
Milner AJ, Shields M, Currier D, King TL. Male-Dominated Occupations, Employment Status, and Suicidal Behaviors Among Australian Men. CRISIS 2019; 41:54-63. [PMID: 31310165 DOI: 10.1027/0227-5910/a000610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Suicide rates are higher among unemployed men as well as those employed in male-dominated occupations such as construction. There has been less research on whether these patterns are similar for suicide ideation and attempt. Aims: In a cohort of 13,892 Australian males, this study examined the relationship between employment status and occupational gender ratio on reported thoughts of suicide and suicide attempts. Method: Men reporting suicide ideation or attempts at Wave 1 were removed from the sample. Logistic regression was used to examine Wave 1 employment status and occupational gender ratio and Wave 2 reported suicide ideation and attempts, controlling for confounders (measured in Wave 1). We conducted a sensitivity analysis controlling for mental health status. Results: Those who were unemployed or not in the labor force had elevated rates of suicide ideation (unemployed OR = 1.91, 95% CI [1.30, 2.82], p = .001; not in the labor force OR = 1.68, 95% CI [1.09, 2.60], p = .020). Those who were not in the labor force had greater odds of attempts (OR = 2.32, 95% CI [1.05, 5.12], p = .037). There was no association between occupational gender ratio and suicide ideation or attempt. Limitations: We only had single item measures of ideation and attempts. Conclusion: There is a need for further investigation into risk factors for suicide among males, both when they are in and out of employment.
Collapse
Affiliation(s)
- Allison J Milner
- Centre for Health Equity, The University of Melbourne, VIC, Australia
| | - Marissa Shields
- Centre for Health Equity, The University of Melbourne, VIC, Australia
| | - Dianne Currier
- Centre for Mental Health, The University of Melbourne, VIC, Australia
| | - Tania L King
- Centre for Health Equity, The University of Melbourne, VIC, Australia
| |
Collapse
|
237
|
Choo CC, Harris KM, Chew PKH, Ho RC. Clinical assessment of suicide risk and suicide attempters' self-reported suicide intent: A cross sectional study. PLoS One 2019; 14:e0217613. [PMID: 31276556 PMCID: PMC6611556 DOI: 10.1371/journal.pone.0217613] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 12/22/2018] [Indexed: 11/19/2022] Open
Abstract
This study explored medical doctors’ clinical assessment of suicide risk and suicide attempters’ self-reported suicide intent. Three years of archival assessment records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Records related to 460 suicide attempters (70.4% females; 28.6% males) were analysed using logistic regressions. Their ages ranged from 12 to 85 (M = 29.08, SD = 12.86). The strongest predictor of suicide intent was habitual poor coping, followed by serious financial problems, and expressed regret. The strongest predictor of suicide risk was hiding the attempt followed by prior planning. The findings were discussed in regards to implications in clinical assessments and suicide prevention efforts.
Collapse
Affiliation(s)
- Carol C. Choo
- College of Healthcare Sciences, James Cook University, Singapore, Singapore
- * E-mail:
| | - Keith M. Harris
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Peter K. H. Chew
- College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Roger C. Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
- Centre of Excellence in Behavioral Medicine, Nguyen Tat Thanh University (NTTU), Ho Chi Minh City, Vietnam
| |
Collapse
|
238
|
Chiu YC, Liu SI, Lin CJ, Huang YH, Fang CK, Sun FJ, Kao KL, Huang YP, Wu SI. The Psychometric Properties in the Chinese Version of the Reasons for Living Inventory and the Relationship with Suicidal Behaviors Among Psychiatric Patients in Taiwan. Behav Med 2019; 45:197-209. [PMID: 29558316 DOI: 10.1080/08964289.2018.1444577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examines the reliability, factor structure, convergent, and construct validities of the Mandarin Chinese version of the Reasons For Living Inventory (RFL) among Taiwanese psychiatric patients. Demographical characteristics of patients who hold these adaptive cognitions and differences on the level of endorsement between suicidal and non-suicidal individuals were also investigated. All adult patients that had visited the psychiatric ambulatory clinic or had been admitted to the psychiatric ward in a general hospital in Taiwan over a 3-month period were consecutively invited to complete an inventory that included background information, the Mandarin Chinese versions of the RFL, the Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the Beck Hopeless Scale (BHS). Of the 254 respondents aged 19 to 65 years, 47.2% had suicidal ideations or attempts within the past year. The original six-factor structure of the American version was confirmed to be acceptable. The Cronbach α was 0.964.Total scores on RFL were inversely and significantly correlated with that from BHS. Multivariate analysis with demographic data and items from SBQ-R revealed that higher scores on the RFL have been associated with married, have children or religious beliefs, fewer past and current suicidal ideations and attempts, fewer histories of suicidal threats, and a less self-reported likelihood of future suicide in our sample. The Mandarin version of the RFL inventory showed acceptable psychometric properties and could distinguish suicidal patients from non-suicidal ones.
Collapse
Affiliation(s)
- Yu-Chuan Chiu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
| | - Shen-Ing Liu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan.,c Department of Medical Research, Mackay Memorial Hospital , Taipei , Taiwan
| | - Chen-Ju Lin
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Yu-Hsin Huang
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Chun-Kai Fang
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan
| | - Fang-Ju Sun
- c Department of Medical Research, Mackay Memorial Hospital , Taipei , Taiwan
| | - Kai-Liang Kao
- d Department of Pediatrics, Far Eastern Memorial Hospital , Taipei , Taiwan
| | - Yo-Ping Huang
- e Department of Electrical Engineering, National Taipei University of Technology , Taipei , Taiwan
| | - Shu-I Wu
- a Department of Medicine, Mackay Medical College , Taipei , Taiwan.,b Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
| |
Collapse
|
239
|
Ram D, Chandran S, Sadar A, Gowdappa B. Correlation of Cognitive Resilience, Cognitive Flexibility and Impulsivity in Attempted Suicide. Indian J Psychol Med 2019; 41:362-367. [PMID: 31391670 PMCID: PMC6657482 DOI: 10.4103/ijpsym.ijpsym_189_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
CONTEXT Impaired cognitive flexibility and resilience and increased impulsivity are presumed to underlie an attempt of suicide. There is, however, a paucity of research examining their relationship in those who attempted suicide. AIMS To know the correlation of cognitive flexibility and resilience and impulsivity in attempted suicide. MATERIALS AND METHODS Two hundred seventy subjects with suicide attempt (s) were assessed with sociodemographic and clinical proforma, cognitive flexibility scale (CFS), cognitive resilience scale (CRS), and Barratt impulsiveness scale (BIS-15). STATISTICAL ANALYSIS USED Descriptive statistics, linear regression model. RESULTS Mean scores on CFS, CRS, and BIS-15 were 44.93 (SD ± 2.50), 4.49 (SD ± 0.25), and 36.13(SD ± 2.13), respectively. On linear regression analysis, BIS-15 nonplanning had statistically significant negative correlation with CFS and CRS scores, and BIS-15 attention had a positive correlation with CFS and CRS scores. CFS and CRS scores were positively correlated. CONCLUSIONS In attempted suicide, cognitive flexibility and resilience are interrelated positively and inversely associated with impulsivity (nonplanning and inattention).
Collapse
Affiliation(s)
- Dushad Ram
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Suhas Chandran
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Aarsha Sadar
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Basavana Gowdappa
- Department of Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
| |
Collapse
|
240
|
Wolford-Clevenger C, Kuhlman S, Elledge LC, Smith PN, Stuart GL. A Preliminary Validation of the Suicidal Behavior Exposure Scale. PSYCHOLOGY OF VIOLENCE 2019; 9:442-450. [PMID: 31934496 PMCID: PMC6956861 DOI: 10.1037/vio0000170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Research on suicide contagion has suggested that exposure to suicide-related thoughts and behaviors of others promotes one's personal risk for suicide. However, our understanding of the role suicidal exposure plays in the development of suicide risk is underdeveloped. This limited understanding may be due, in part, to the lack of a validated measure of exposure to suicidal behavior. The present study aimed to develop and validate a comprehensive self-report instrument of exposure to suicidal behaviors. METHOD Using two independent convenience samples of undergraduate students, exploratory structural equation modeling (ESEM) was performed on a newly developed measure of suicidal exposure. RESULTS Data supported a three-factor model of suicidal exposure: exposure to suicidal communication, direct exposure to suicide deaths and attempts, and indirect exposure to suicide deaths and attempts. Each factor demonstrated positive bivariate associations with depressive symptoms, posttraumatic stress disorder symptoms, suicide ideation, and suicide attempt history, suggesting convergent validity. Analyses demonstrated generally acceptable internal consistency. CONCLUSION This instrument will facilitate the study of suicidal exposure. Further validation of this scale, with attention to its reliability and invariance across gender and other demographic variables in clinically relevant samples, will be important for advancing the assessment of suicidal exposure and understanding its relation to suicide risk.
Collapse
|
241
|
Hemming L, Taylor P, Haddock G, Shaw J, Pratt D. A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour. J Affect Disord 2019; 254:34-48. [PMID: 31103905 PMCID: PMC6599888 DOI: 10.1016/j.jad.2019.05.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alexithymia reflects a difficulty with identifying and expressing emotions. This experience has been proposed as having an association with suicide ideation and behaviour. This review aimed to synthesise the evidence to establish the bivariate and multivariate relationships between alexithymia, and its subcomponents, with suicide ideation and behaviour. METHODS Search terms related to alexithymia and suicide ideation and behaviour were searched across nine prominent databases in May 2018. Studies were eligible for inclusion if they reported original empirical quantitative findings from adult samples, used a validated measure of alexithymia, and any measure of suicide ideation or behaviour. RESULTS Thirty-four studies were eligible for inclusion in this review. The review found a large effect size for the relationship between alexithymia and suicide ideation (r = 0.54, 95% CI= 0.40-0.65) and a small effect size for the relationship between alexithymia and suicide behaviour (r = 0.25, 95% CI = 0.16-0.34). LIMITATIONS A high level of heterogeneity was found in the meta-analysis meaning that results should be interpreted with caution. CONCLUSION A positive association was found between alexithymia and suicide ideation and, to a lesser extent, behaviour across a range of clinical and general population samples. This review has potentially important clinical implications, and promotes the need for suicide prevention to focus on emotion regulation skills.
Collapse
Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK.
| | - Peter Taylor
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| |
Collapse
|
242
|
Ordóñez-Carrasco JL, Cuadrado Guirado I, Rojas Tejada A. Scale of psychological pain: Spanish adaptation of the Psychache Scale in young adults. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 15:S1888-9891(19)30051-5. [PMID: 31171488 DOI: 10.1016/j.rpsm.2019.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Psychological pain is understood as an intolerable and disturbing mental state characterized by an internal experience of negative emotions. This study was aimed at making a Spanish adaptation of the Psychache Scale by Holden and colleagues in a sample of young adults. MATERIAL AND METHODS The scale evaluates psychological pain as a subjective experience. It is composed of 13 items with a Likert-type response format. Following the guidelines of the International Tests Commission for the adaptation of the test, we obtained a version conceptually and linguistically equivalent to the original scale. Through an online questionnaire, participants completed the psychological pain scale along with other scales to measure depression (BDI-II), hopelessness (Beck's scale of hopelessness) and suicide risk (Plutchik suicide risk scale). The participants were 234 people (94 men, 137 women and three people who identified as a different sex) from 18 to 35 years old. RESULTS The EFA showed a one-factor solution, and the FCA revealed adequate indexes of adjustment to the unifactorial model. It also showed good reliability of the test scores. The evidence of validity of the scale in relation to the other variables showed high, positive and statistically significant correlations with depression, hopelessness, suicidal ideation and suicidal risk. CONCLUSION In summary, this Spanish adaptation of the Psychache Scale could contribute to improving the evaluation of both the patient with suicide risk and the effectiveness of psychological therapy, as well as suicidal behaviour prevention and intervention.
Collapse
|
243
|
Ahn J, Lee JH, Jung YC. Predictors of Suicide Attempts in Individuals with Eating Disorders. Suicide Life Threat Behav 2019; 49:789-797. [PMID: 29882994 DOI: 10.1111/sltb.12477] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Although suicide is a major cause of mortality for individuals with eating disorders (EDs), researches about potential factors predicting suicide attempts in ED are insufficient. We sought to identify factors associated with suicide attempts in ED. METHOD A total of 899 patients with ED were assessed via structured interviews. To compare demographic and clinical characteristics of those who had attempted suicide with those who had not, we used chi-square tests and independent t tests for categorical and continuous variables, respectively. Then, binary logistic regression was conducted to identify factors associated with a history of suicide attempt. RESULTS Among ED patients, 20.8% reported a history of suicide attempts. Among the whole sample, the diagnostic category was the most significant factor. History of self-mutilating behavior, hospitalization history, comorbid depression, and impulse regulation were also important factors associated with suicide attempt. Within the subgroup, comorbid anxiety disorder, depression, and BMI in anorexia nervosa and hospitalization history, history of self-mutilating behavior, comorbid depression, illness duration, and poor impulse regulation in bulimia nervosa were significant factors associated with suicide attempt. CONCLUSIONS Because modifying risk factors of suicide attempt is important for preventing completed suicide, clinicians should carefully evaluate and monitor the risk factors of suicide attempt.
Collapse
Affiliation(s)
- Jaeun Ahn
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
244
|
Negative life events as triggers on suicide attempt in rural China: a case-crossover study. Psychiatry Res 2019; 276:100-106. [PMID: 31035109 DOI: 10.1016/j.psychres.2019.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/24/2022]
Abstract
This study aims to investigate the potential triggering of negative life events (NLEs) on suicide attempt in rural China. A case-crossover design was used to study 1200 suicide attempters aged 15-70 years. NLEs were assessed by a modification of Paykel's Interview for Recent Life Events. NLEs had significant triggering effects on the day of and month of suicide attempt. Marriage/love, family/home, and friend/relationship were the types of NLEs found to trigger suicide attempt when occurring on the day and month of suicide attempt. Specifically, increased risk of suicide attempt was associated with quarreling with a partner or family member on the day and month of suicide attempt. Being disappointed in a love affair, fighting with a partner, family poverty and loss of face during the month of attempts were linked to increase odds of suicide attempt. Further, when month of suicide attempt was assigned as the case period, the impact of NLEs on suicide attempt was greater among those who were younger and without mental disorders. These findings provide knowledge of the triggering of NLEs on suicide attempt, especially among the young and those without mental disorders. Further, family conflicts should be a greater focus of attention in suicide prevention.
Collapse
|
245
|
Huber RS, Subramaniam P, Kondo DG, Shi X, Renshaw PF, Yurgelun-Todd DA. Reduced lateral orbitofrontal cortex volume and suicide behavior in youth with bipolar disorder. Bipolar Disord 2019; 21:321-329. [PMID: 30471169 DOI: 10.1111/bdi.12729] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Structural abnormalities in cortical and subcortical regions, including the orbitofrontal cortex (OFC), are altered during brain development in adolescents with bipolar disorder (BD), which may increase risk for suicide. Few studies have examined the neural substrates of suicidal behavior in BD youth. The aim of the present study was to investigate the relationship between suicide behavior and the OFC in youth with BD. METHODS Thirty-seven participants with BD and 26 non-psychiatric controls, ages 13-21 years, completed a diagnostic interview and mood rating scales. Lifetime symptoms of suicide ideation and behavior were examined using the Columbia Suicide Severity Rating Scale. Participants underwent magnetic resonance imaging on a 3T Siemens Verio scanner. Morphometric analysis of brain images was performed using FreeSurfer. RESULTS Eighteen participants with BD had a history of suicide attempt (SA). Bipolar youth with a history of SA showed reduced left lateral OFC volumes compared to controls, but there was no difference between BD attempters and non-attempters. Controls and BD non-attempters had significantly greater OFC cortical thickness than BD attempters. Additionally, there was a significant negative correlation between OFC volumes and suicide lethality, demonstrating that as suicide lethality increased, OFC volume in BD youth was reduced. CONCLUSIONS The OFC is involved in decision-making, impulsivity, and reward circuitry which have shown to be impaired in BD. Reduced OFC volume and its association with lethality of suicide suggest that suicide behavior in BD may be related to the emerging neuroanatomical substrates of the disorder, particularly abnormalities of the OFC.
Collapse
Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Punitha Subramaniam
- Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Douglas G Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
| | - Xianfeng Shi
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
| |
Collapse
|
246
|
Wolford-Clevenger C, Smith PN, Kuhlman S, D'Amato D. A Preliminary Test of the Interpersonal-Psychological Theory of Suicide in Women Seeking Shelter From Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:2476-2497. [PMID: 27456533 DOI: 10.1177/0886260516660974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Women seeking shelter from intimate partner violence (IPV) are at greater risk of suicide ideation and attempts compared with women in the general population. A theoretically grounded understanding of suicide risk in shelter-seeking women is critical to improve assessment and management of suicide risk in this population. The interpersonal-psychological theory of suicide (IPTS) proposes that suicide ideation results from hopelessness about thwarted belongingness and perceived burdensomeness. However, suicide ideation does not progress to death by suicide unless one has acquired the capability for suicide (i.e., pain tolerance and fearlessness about death) via repeated exposure to painful and fearsome events. The present study provides a preliminary test of the IPTS in a sample of 134 women seeking shelter from IPV. First, we examined factors theoretically related to suicide ideation, demonstrating that only at high levels of hopelessness was perceived burdensomeness associated with suicide ideation. The study also examined factors theoretically related to the acquired capability for suicide (ACS), indicating that physical partner violence perpetration was associated with ACS. These findings suggest that perceived burdensomeness, particularly in the context of increased hopelessness, is important in the assessment and treatment of suicide ideation. Furthermore, violence perpetration may indicate greater risk of the capability to die by suicide among women seeking shelter from IPV.
Collapse
|
247
|
Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents. Epidemiol Psychiatr Sci 2019; 28:280-289. [PMID: 29022520 PMCID: PMC6998902 DOI: 10.1017/s2045796017000488] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Suicidal behaviour is prevalent among adolescents and is a significant predictor of future suicide attempts (SAs) and suicide death. Data on the prevalence and epidemiological characteristics of suicidal behaviour in Chinese adolescents are limited. This study was aimed to examine the prevalence, characteristics and risk factors of suicidal behaviour, including suicidal thought (ST), suicide plan (SP) and SA, in a large sample of Chinese adolescents. METHOD This report represents the first wave data of an ongoing longitudinal study, Shandong Adolescent Behavior and Health Cohort. Participants included 11 831 adolescent students from three counties of Shandong, China. The mean age of participants was 15.0 (s.d. = 1.5) and 51% were boys. In November-December 2015, participants completed a structured adolescent health questionnaire, including ST, SP and SA, characteristics of most recent SA, demographics, substance use, hopelessness, impulsivity and internalising and externalising behavioural problems. RESULTS The lifetime and last-year prevalence rates were 17.6 and 10.7% for ST in males, 23.5 and 14.7% for ST in females, 8.9 and 2.9% for SP in males, 10.7 and 3.8% for SP in females, 3.4 and 1.3% for SA in males, and 4.6 and 1.8% for SA in females, respectively. The mean age of first SA was 12-13 years. Stabbing/cutting was the most common method to attempt suicide. Approximately 24% of male attempters and 16% of female attempters were medically treated. More than 70% of attempters had no preparatory action. Female gender, smoking, drinking, internalising and externalising problems, hopelessness, suicidal history of friends and acquaintances, poor family economic status and poor parental relationship were all significantly associated with increased risk of suicidal behaviour. CONCLUSIONS Suicidal behaviour in Chinese adolescents is prevalent but less than that previously reported in Western peers. While females are more likely to attempt suicide, males are more likely to use lethal methods. Multiple child and family factors are associated with suicidal behaviour. These findings highlight the importance of early screening and intervention of suicidal behaviour in Chinese adolescents.
Collapse
|
248
|
Liu X, Liu X, Sun J, Yu NX, Sun B, Li Q, Zhu T. Proactive Suicide Prevention Online (PSPO): Machine Identification and Crisis Management for Chinese Social Media Users With Suicidal Thoughts and Behaviors. J Med Internet Res 2019; 21:e11705. [PMID: 31344675 PMCID: PMC6682269 DOI: 10.2196/11705] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/02/2018] [Accepted: 03/30/2019] [Indexed: 12/29/2022] Open
Abstract
Background Suicide is a great public health challenge. Two hundred million people attempt suicide in China annually. Existing suicide prevention programs require the help-seeking initiative of suicidal individuals, but many of them have a low motivation to seek the required help. We propose that a proactive and targeted suicide prevention strategy can prompt more people with suicidal thoughts and behaviors to seek help. Objective The goal of the research was to test the feasibility and acceptability of Proactive Suicide Prevention Online (PSPO), a new approach based on social media that combines proactive identification of suicide-prone individuals with specialized crisis management. Methods We first located a microblog group online. Their comments on a suicide note were analyzed by experts to provide a training set for the machine learning models for suicide identification. The best-performing model was used to automatically identify posts that suggested suicidal thoughts and behaviors. Next, a microblog direct message containing crisis management information, including measures that covered suicide-related issues, depression, help-seeking behavior and an acceptability test, was sent to users who had been identified by the model to be at risk of suicide. For those who replied to the message, trained counselors provided tailored crisis management. The Simplified Chinese Linguistic Inquiry and Word Count was also used to analyze the users’ psycholinguistic texts in 1-month time slots prior to and postconsultation. Results A total of 27,007 comments made in April 2017 were analyzed. Among these, 2786 (10.32%) were classified as indicative of suicidal thoughts and behaviors. The performance of the detection model was good, with high precision (.86), recall (.78), F-measure (.86), and accuracy (.88). Between July 3, 2017, and July 3, 2018, we sent out a total of 24,727 direct messages to 12,486 social media users, and 5542 (44.39%) responded. Over one-third of the users who were contacted completed the questionnaires included in the direct message. Of the valid responses, 89.73% (1259/1403) reported suicidal ideation, but more than half (725/1403, 51.67%) reported that they had not sought help. The 9-Item Patient Health Questionnaire (PHQ-9) mean score was 17.40 (SD 5.98). More than two-thirds of the participants (968/1403, 69.00%) thought the PSPO approach was acceptable. Moreover, 2321 users replied to the direct message. In a comparison of the frequency of word usage in their microblog posts 1-month before and after the consultation, we found that the frequency of death-oriented words significantly declined while the frequency of future-oriented words significantly increased. Conclusions The PSPO model is suitable for identifying populations that are at risk of suicide. When followed up with proactive crisis management, it may be a useful supplement to existing prevention programs because it has the potential to increase the accessibility of antisuicide information to people with suicidal thoughts and behaviors but a low motivation to seek help.
Collapse
Affiliation(s)
- Xingyun Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoqian Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiumo Sun
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Bingli Sun
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qing Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
249
|
Liu BP, Wang XT, Liu ZZ, Wang ZY, Liu X, Jia CX. Stressful life events, insomnia and suicidality in a large sample of Chinese adolescents. J Affect Disord 2019; 249:404-409. [PMID: 30822663 DOI: 10.1016/j.jad.2019.02.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/12/2022]
Abstract
AIMS This study aimed to examine the associations between stressful life events, insomnia, and suicidality including suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort were included for the analysis. Participants were sampled from 8 middle/high schools in 3 counties of Shandong, China. Participants completed a structured behavior and health questionnaire, including suicidality, demographics, depression/anxiety, stressful life events (SLEs), and insomnia in November-December 2015. A series of logistic regression models and mediation analyses were performed to examine the associations between SLEs, insomnia and suicidality. RESULTS The prevalence rates of overall suicidality, SI, SP and SA in the last year were 13.1%, 12.5%, 3.3%, and 1.5%, respectively. SLEs were significantly associated with overall suicidality, SI, and SP. Insomnia was an independent risk factor of suicidality and a mediator of the association between SLEs and suicidality. The total effect of SLEs on overall suicidality was 0.597 (95%CI: 0.534-0.661), including 0.457 (95%CI: 0.391-0.523) for direct effect and 0.158 (95%CI: 0.138-0.178) for indirect effect. Insomnia also mediated the associations of SLEs with SI, SP and SA, respectively. LIMITATIONS Causal relationship could not be concluded because this study is cross-sectional. CONCLUSIONS Stressful life events and insomnia are directly associated with suicidality in adolescents. The association between SLEs and suicidality is partially mediated by insomnia.
Collapse
Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China.
| |
Collapse
|
250
|
Porras-Segovia A, Pérez-Rodríguez MM, López-Esteban P, Courtet P, Barrigón M ML, López-Castromán J, Cervilla JA, Baca-García E. Contribution of sleep deprivation to suicidal behaviour: A systematic review. Sleep Med Rev 2019; 44:37-47. [DOI: 10.1016/j.smrv.2018.12.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
|