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Hart RK, Christiansen SG, Reneflot A, Hauge LJ. Adolescents' primary care consultations before and after parental suicide: evidence from population-wide data. Eur Child Adolesc Psychiatry 2023; 32:2453-2462. [PMID: 36175569 PMCID: PMC10682049 DOI: 10.1007/s00787-022-02095-3] [Citation(s) in RCA: 1] [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: 02/18/2022] [Accepted: 09/23/2022] [Indexed: 11/03/2022]
Abstract
Parental bereavement is associated with distress and poorer long-term outcomes among adolescents. Adolescents who lose a parent to suicide fare worse than their peers even before bereavement. Based on the current literature, we cannot distinguish such initial differences from the medium and long-term effect of parental suicide. We study the impact of parental suicide on adolescents' General Practitioner visits for mental health or psychosocial reasons. Within-individual models account for time-invariant differences between the bereaved and non-bereaved. We investigate if effects differ from the impact of parental death from other causes, and vary with sex and socioeconomic background. Full population data on Norwegian residents aged 10-19 in the period 2006-2015 are drawn from registers (N = 1 405 suicide bereaved, 12 982 bereaved by other causes, and 1 182 819 non-bereaved controls). Records include data on use of health services, parental mortality, and sociodemographic characteristics of parent and child. Mental health consultations increase gradually in the quarters leading up to the parental suicide, significantly more for girls than for boys. Two years prior to bereavement, 2.4% of the subsequently suicide bereaved have a mental health consultation in any given quarter. In the year of bereavement, this increases with 6% points. Health care workers should be aware that boys are less likely to turn to their GP for support before parental bereavement from suicide.
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Affiliation(s)
- Rannveig K Hart
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway.
| | | | - Anne Reneflot
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
| | - Lars Johan Hauge
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
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Austgulen A, Skram NKG, Haavik J, Lundervold AJ. Risk factors of suicidal spectrum behaviors in adults and adolescents with attention-deficit / hyperactivity disorder - a systematic review. BMC Psychiatry 2023; 23:612. [PMID: 37605105 PMCID: PMC10441735 DOI: 10.1186/s12888-023-05099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Adolescents and adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of suicidal spectrum behaviors (SSBs). However, there is limited knowledge about risk factors triggering SSBs in this group of people. OBJECTIVE To explore published literature concerning factors that may increase the risk of SSBs in adults and adolescents with ADHD. METHODS A systematic literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on 22nd of February 2022 using the Ovid MEDLINE and Web of Science databases. Three categories of search terms were used: (1) self-harm, self-injury, self-mutilation, suicide, self-poisoning; (2) adults, adolescents; and (3) attention-deficit hyperactivity disorder/ADHD. Studies with data concerning mediating factors of SSBs in relation to a clinical diagnosis of ADHD in participants above 16 years of age were included. RESULTS The literature search identified 604 articles, of which 40 were included in the final study selection. Factors found to increase the likelihood of SSBs included ADHD symptom severity and persistence, female gender, family history of ADHD, childhood and parental influences, and social functioning. Even when adjusting for psychiatric comorbidities, most studies showed that adults and adolescents with ADHD have an elevated risk of SSBs. CONCLUSION This systematic review has documented that several demographic and clinical features are associated with an increased risk of SSBs in adolescents and adults with ADHD. Notably, ADHD emerges as an independent risk factor for SSBs. This information ought to have clinical implications in terms of screening and suicide prevention strategies. Further longitudinal studies are needed to investigate the outcome of preventive strategies in individuals along the full spectrum of ADHD symptom severity.
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Affiliation(s)
- Amalie Austgulen
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway
| | - Nanna Karen Gilberg Skram
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway.
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Ortin-Peralta A, Keski-Säntti M, Gissler M, Veijola J, Sourander A, Duarte CS. Parental suicide attempts and offspring's risk of attempting or dying by suicide: does the timing of a parental suicide attempt matter? Psychol Med 2023; 53:977-986. [PMID: 34140058 DOI: 10.1017/s0033291721002397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies on the transmission of suicide risk have focused on parental history of suicide attempts (SAs), overlooking when the attempt happened. This study examined how the offspring's risk of attempting or dying by suicide varied by the timing of a first parental SA and the sex of the parent who attempted suicide. METHODS Participants were 59 469 members of the 1987 Finnish Birth Cohort. The Finnish Hospital Discharge and Cause of Death Registers were the sources for parental and offspring SAs and offspring suicide. Timing of parental SA was coded as before (pre-pregnancy and pregnancy) and after the child's birth [infant/toddler years (0-2 years), childhood (3-11 years), adolescence (12-17 years), and young adulthood (18-26 years)]. RESULTS In the multivariate models, having a parent who attempted suicide increased the offspring's risk of attempting suicide (odds ratio (OR) = 1.77, 95% confidence interval (CI) 1.39-2.25), but not of dying by suicide. Compared to unexposed offspring, those exposed after child's birth were at higher risk of attempting suicide (OR = 1.90, 95% CI 1.46-2.47), specifically when the parent attempted during offspring's childhood, adolescence, and young adulthood. A first maternal SA increased offspring's risk of attempting suicide regardless of the timing. CONCLUSIONS The impact of a parental SA on offspring's risk of attempting suicide differed depending on the timing and sex of the parent who attempted suicide, suggesting that the transmission of suicide risk may occur through genetic as well as environmental factors. Our findings call for an intergenerational approach in suicide risk assessment.
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Affiliation(s)
- Ana Ortin-Peralta
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | | | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Juha Veijola
- Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
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Çavdar Toraman M, Sarigedik E, Özçetin A. Evaluation of Psychological Resilience, Alexithymia, and Impulsivity Characteristics in Persons Who Attempted Suicide with Drugs. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221142092. [PMID: 36441644 DOI: 10.1177/00302228221142092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE In this study, it was aimed to research the connection between psychological resilience, alexithymia, depression, anxiety and impulsivity in patients who attempted suicide with drugs. METHODS The patient group (n = 66) who attempted suicide with drugs and the control group (n = 66) without any psychiatric diagnosis were examined in the study. Sociodemographic data form, Psychological Resilience Scale, Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory, Beck Anxiety Inventory, Barratt Impulsivity Scale (BIS-11) were used in the study. RESULTS It was found that PRS dedication and challenge are significantly higher in the control group (p = .039 and p = .003, respectively). When the undiagnosed group who attempted suicide were compared with the control group, it was observed that there is a significant difference between BIS-11 total and TAS total after bonferonni correction (respectively; p = .002; p = .001), while, there is no statistically significant difference in terms of PRS total score (p = .483). CONCLUSION It was observed that patients who attempted suicide with drugs had low levels of psychological resilience, high alexithymia levels. In the absence of an additional diagnosis of depression, psychological resilience did not differ in terms of suicide attempts. In the suicide group, those who did not receive any additional diagnosis were not more impulsive than those who were depressed.
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Affiliation(s)
| | - Enes Sarigedik
- Department of Child and Adolescent Psychiatry, Sakarya University, Sakarya, Turkey
| | - Adnan Özçetin
- Department of Psychiatry, Duzce University, Duzce, Turkey
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Ranning A, Uddin MJ, Sørensen HJ, Laursen TM, Thorup AAE, Madsen T, Nordentoft M, Erlangsen A. Intergenerational transmission of suicide attempt in a cohort of 4.4 million children. Psychol Med 2022; 52:3202-3209. [PMID: 33827720 DOI: 10.1017/s0033291720005310] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The association between suicide attempts (SAs) in parents and children is unclear, and risk indicators for intergenerational transmission remain undocumented. We aimed to assess this association, considering the child's developmental period at the time of parents' attempted suicide, and the parental relation. METHODS Using a prospective cohort design, nationwide population data were linked to the Psychiatric Central Register and National Patient Register for all individuals aged 10 years or older living in Denmark between 1980 and 2016. We assessed incidence rate ratios (IRRs) and cumulative hazards for children's first SA. RESULTS In a cohort of 4 419 651 children, 163 056 (3.7%) had experienced a parental SA. An SA was recorded among 6996 (4.3%) of the exposed children as opposed to 70112 (1.6%) in unexposed individuals. Higher rates were noted when a parental SA occurred during early childhood (0 ⩽ age < 2) [IRR, 4.7; 95% confidence interval (CI) 4.2-5.4] v. late childhood (6 ⩽ age < 13) (IRR, 3.6; 95% CI 3.4-3.8) when compared to those unexposed. Children exposed prior to age 2 had the highest rates of all sub-groups when reaching age 13-17 (IRR, 6.5; 95% CI 6.0-7.1) and 18-25 years (IRR, 6.8; 95% CI 6.2-7.4). Maternal SA (IRR, 3.4; 95% CI 3.2-3.5) was associated with higher rates than paternal (IRR, 2.8; 95% CI 2.7-2.9). CONCLUSION Parental SA was associated with children's own SA. Exposure during early developmental stages was associated with the highest rates. Early preventive efforts are warranted as is monitoring of suicide risk in the children from age 13.
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Affiliation(s)
- Anne Ranning
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Md Jamal Uddin
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | | | - Thomas Munk Laursen
- National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Anne A E Thorup
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Denmark
| | - Trine Madsen
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Copenhagen, Denmark
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center of Mental Health Research, Australian National University, Canberra, Australia
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Helgesson M, Björkenstam E, Filatova S, Rahman SG, Cullen A, Dorner T, Gémes K, Amin R, Mittendorfer-Rutz E. Mental and somatic disorders and the subsequent risk of all-cause and cause-specific mortality in refugees, non-refugee migrants and the Swedish-born youth: a population-based cohort study in Sweden. BMJ Open 2022; 12:e054351. [PMID: 35545376 PMCID: PMC9096569 DOI: 10.1136/bmjopen-2021-054351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/24/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aims were to investigate the associations between specific mental and somatic disorders and subsequent all-cause and cause-specific mortality (suicide, external and other causes) in young refugees and non-refugee migrants compared with Swedish-born individuals of similar age. METHODS In this register-based prospective cohort study, all 1 003 760 individuals (40 305 refugees, 31 687 non-refugee migrants as the exposure groups and the rest as the Swedish-born comparison group), 16-25 years old, residing in Sweden on 31 December 2004 were included. These individuals were followed regarding the outcome of all-cause and cause-specific mortality (suicide and external causes) between 2005 and 2016. The study population was also stratified according to any use of specialised healthcare for mental or somatic diagnoses before baseline (2000-2004). Cox regression models yielding crude and multivariate Hazard Ratios (HR and aHR, respectively) with 95% Confidence Intervals (CI) were used to investigate the afore-mentioned associations. RESULTS A lower proportion of both refugees (12%) and non-refugee migrants (10%) had college/university education compared with the Swedish-born individuals (17%). The proportion of unemployed (>180 days) among refugees (2.3%) and non-refugees (2.9%) was higher than the Swedish born (1.4%). Refugees and non-refugee migrants had about a 20% lower risk of all-cause mortality and external causes of mortality compared with Swedish-born individuals. An even greater reduction in suicide risk (aHR 0.51, 95% CI 0.37 to 0.70, and 0.63, 95% CI 0.49 to 0.82 for non-refugees and refugees, respectively) was found. When restricted to those with a mental or somatic disorder, a lower risk of both general and specific mortality was also found among both refugees and non-refugee migrants compared with Swedish-born individuals. Refugees had, however, equal point estimates of all-cause mortality associated with substance misuse disorder and neoplasms as their Swedish-born peers with these disorders. CONCLUSIONS With few exceptions, young migrants with specific mental and somatic disorders have a mortality advantage compared with their Swedish-born peers with the same disorders. Further research on protective factors is warranted.
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Affiliation(s)
- Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Svetlana Filatova
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Syed Ghulam Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alexis Cullen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, King's College London, London, UK
| | - Thomas Dorner
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Katalin Gémes
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ridwanul Amin
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Benson R, Rigby J, Brunsdon C, Cully G, Too LS, Arensman E. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095313. [PMID: 35564710 PMCID: PMC9099648 DOI: 10.3390/ijerph19095313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
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Affiliation(s)
- Ruth Benson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Correspondence:
| | - Jan Rigby
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Christopher Brunsdon
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia;
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
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Parental mental health and risk of poor mental health and death by suicide in offspring: a population-wide data-linkage study. Epidemiol Psychiatr Sci 2022; 31:e25. [PMID: 35438075 PMCID: PMC9069591 DOI: 10.1017/s2045796022000063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIMS Suicide is a major public health concern. Identifying those most at risk is vital to ensure the implementation of effective interventions. Mental health (MH) is known to have a genetic component and parental MH is associated with offspring MH. However, little is known about the effect of parental psychopathology on offspring suicide risk. The aim of this study is to determine if children living with parents with poor MH are at an increased risk of poor MH, or death by suicide. METHODS This population-wide cohort study linked data from the 2011 Northern Ireland Census to 6 years' death records (2011-2016). Information on MH status, in addition to other individual and household-level attributes, was derived from the 2011 Census. Logistic regression was utilised to examine the association between parental poor MH and offspring MH and suicide risk, with adjustment for socio-demographic characteristics. RESULTS Overall, 11.6% of the cohort of 618 970 individuals were residing with parents who reported poor MH; 1.6% reported poor MH themselves, and 0.04% (n = 260) died by suicide. Living with a parent with poor MH increased the odds of offspring poor MH (OR = 2.80, 95% CI 2.59-3.03). After adjustment for age, gender, physical illness, socio-economic status and own MH, children living with 1 parent with poor MH were 76% more likely to die by suicide compared to children of parents who did not report poor MH (OR = 1.76, 95% CI 1.31-2.36). The effect size increased for children living with 2 parents with poor MH, and was higher in children aged under 24 years. CONCLUSIONS Living with a parent with poor MH is a significant risk factor for offspring poor MH and suicide, even after adjustment for personal MH status. When treating mental ill-health in parents, potential interventions for their children should also be considered.
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Kline EA, Ortin-Peralta A, Polanco-Roman L, Miranda R. Association Between Exposure to Suicidal Behaviors and Suicide Attempts Among Adolescents: The Moderating Role of Prior Psychiatric Disorders. Child Psychiatry Hum Dev 2022; 53:365-374. [PMID: 33569742 DOI: 10.1007/s10578-021-01129-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
Theories suggest that adolescents exposed to suicide attempts and/or deaths are at higher risk of attempting suicide, themselves. However, research findings have been mixed, with most studies not accounting for psychiatric vulnerability. We examined past psychiatric diagnosis as a moderator of the association between lifetime exposure to suicide attempts and/or deaths and adolescents' suicide attempts. Adolescents (N = 518; 60% female; 45% White), ages 12-21, reported on prior suicide ideation and attempts, and mood, anxiety, and substance use disorders at baseline. Suicide attempts since baseline and exposure to suicidal behaviors were assessed 4-6 years later. Lifetime exposure to family suicide attempts and/or suicide deaths, but not to suicidal behaviors of peers/friends or others, was associated with a suicide attempt at follow-up among those with prior psychiatric disorders. Psychologically vulnerable adolescents may require additional support after exposure to suicidal behaviors of a family member to reduce their risk of attempting suicide.
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Affiliation(s)
- Emily A Kline
- Hunter College, City University of New York, New York, USA.,Montclair State University, Montclair, USA
| | - Ana Ortin-Peralta
- Hunter College, City University of New York, New York, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Lillian Polanco-Roman
- Columbia University Medical Center, New York State Psychiatric Institute, New York, USA.,The New School for Social Research, New York, USA
| | - Regina Miranda
- Hunter College, City University of New York, New York, USA. .,The Graduate Center, City University of New York, New York, USA. .,Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA.
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10
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Calderaro M, Baethge C, Bermpohl F, Gutwinski S, Schouler-Ocak M, Henssler J. Offspring's risk for suicidal behaviour in relation to parental death by suicide: systematic review and meta-analysis and a model for familial transmission of suicide. Br J Psychiatry 2022; 220:121-129. [PMID: 35049479 DOI: 10.1192/bjp.2021.158] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Exposure to parental suicide has been associated with increased risk for suicide and suicide attempts, although the strength of this association is unclear as evidence remains inconsistent. AIMS To quantify this risk using meta-analysis and identify potential effect modifiers. METHOD A systematic search in PubMed, PsycInfo and Embase databases to 2020 netted 3614 articles. Inclusion criteria were: observation of history of parental death by suicide, comparison with non-exposed populations and definition of suicide and suicide attempt according to standardised criteria. We focused on population-based studies. The primary outcome was the pooled relative risk (RR) for incidence of suicide attempt and suicide in offspring of a parent who died by suicide compared with offspring of two living parents. Additionally, we compared the RR for attempted and completed suicide after parental suicide with the RR for attempted and completed suicide after parental death by other causes. RESULTS Twenty studies met our inclusion criteria. Offspring exposed to parental suicide were more likely to die by suicide (RR = 2.97, 95% CI 2.50-3.53) and attempt suicide (RR = 1.76, 95% CI 1.58-1.96) than offspring of two living parents. Furthermore, their risk of dying by or attempting suicide was significantly higher compared with offspring bereaved by other causes of death. CONCLUSIONS The experience of losing a parent to suicide is a strong and independent risk factor for suicidal behaviour in offspring. Our findings highlight the need for prevention strategies, outreach programmes and support interventions that target suicide-related outcomes in the exposed population.
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Affiliation(s)
- Mara Calderaro
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin,Germany; and Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Germany; and Pettenkofer School of Public Health, Munich, Germany
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin,Germany
| | - Stefan Gutwinski
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin,Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin,Germany
| | - Jonathan Henssler
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin,Germany; and Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Germany
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11
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Wang J, Naifeh JA, Mash HBH, Morganstein JC, Fullerton CS, Cozza SJ, Stein MB, Ursano RJ. Parental suicide attempt and subsequent risk of pre-enlistment suicide attempt among male and female new soldiers in the U.S. Army. Suicide Life Threat Behav 2022; 52:59-68. [PMID: 34060122 DOI: 10.1111/sltb.12772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/29/2021] [Accepted: 03/11/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Suicide and suicide attempts among U.S. Army soldiers are a significant concern for public health. This study examined the association of parental suicide attempt prior to age 13 of the soldier with subsequent risk of pre-enlistment suicide attempt. METHOD We conducted secondary analyses of survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (N = 38,396). A series of logistic regression analyses were conducted. RESULTS Of all new soldiers, 1.4% reported that they attempted suicide between age 13 and entering the Army, and 2.3% reported a parental suicide attempt prior to age 13. Parental suicide attempt was associated with increased odds of subsequent suicide attempt; however, this association was moderated by gender and was significant only among male soldiers. The association between parental suicide attempt and pre-enlistment suicide attempt among male soldiers was still significant after controlling for socio-demographic characteristics, soldier/parental psychopathology, and childhood adversities. CONCLUSIONS These results highlight parental suicide attempt as a unique pre-enlistment risk factor for suicide attempt, especially among male new soldiers. Further studies are needed to separate the genetic and environmental contributions to intra-familial risk for suicidal behavior.
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Affiliation(s)
- Jing Wang
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - James A Naifeh
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Holly B Herberman Mash
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Joshua C Morganstein
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Stephen J Cozza
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress (CSTS), Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD, USA
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12
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Dombrovski AY, Hallquist MN. Search for solutions, learning, simulation, and choice processes in suicidal behavior. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2022; 13:e1561. [PMID: 34008338 PMCID: PMC9285563 DOI: 10.1002/wcs.1561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/06/2021] [Accepted: 04/07/2021] [Indexed: 12/25/2022]
Abstract
Suicide may be viewed as an unfortunate outcome of failures in decision processes. Such failures occur when the demands of a crisis exceed a person's capacity to (i) search for options, (ii) learn and simulate possible futures, and (iii) make advantageous value-based choices. Can individual-level decision deficits and biases drive the progression of the suicidal crisis? Our overview of the evidence on this question is informed by clinical theory and grounded in reinforcement learning and behavioral economics. Cohort and case-control studies provide strong evidence that limited cognitive capacity and particularly impaired cognitive control are associated with suicidal behavior, imposing cognitive constraints on decision-making. We conceptualize suicidal ideation as an element of impoverished consideration sets resulting from a search for solutions under cognitive constraints and mood-congruent Pavlovian influences, a view supported by mostly indirect evidence. More compelling is the evidence of impaired learning in people with a history of suicidal behavior. We speculate that an inability to simulate alternative futures using one's model of the world may undermine alternative solutions in a suicidal crisis. The hypothesis supported by the strongest evidence is that the selection of suicide over alternatives is facilitated by a choice process undermined by randomness. Case-control studies using gambling tasks, armed bandits, and delay discounting support this claim. Future experimental studies will need to uncover real-time dynamics of choice processes in suicidal people. In summary, the decision process framework sheds light on neurocognitive mechanisms that facilitate the progression of the suicidal crisis. This article is categorized under: Economics > Individual Decision-Making Psychology > Emotion and Motivation Psychology > Learning Neuroscience > Behavior.
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Affiliation(s)
| | - Michael N. Hallquist
- Department of Psychology and NeuroscienceUniversity of North CarolinaChapel HillNorth CarolinaUSA
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13
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Suicidal behaviours in the peripartum period: a systematic scoping review of data linkage studies. Arch Womens Ment Health 2021; 24:579-593. [PMID: 33742281 DOI: 10.1007/s00737-021-01102-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/11/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this scoping review was to summarize research that uses linked data to examine peripartum suicidal behaviours and critically appraise studies to identify evidence gaps and future research priorities. A systematic search of PubMed, Scopus, and grey literature was undertaken to identify data linkage studies that examined suicidal behaviours among women in the peripartum period. All articles available through PubMed and Scopus up until the search date of 26 September 2019 were deemed eligible for inclusion. A grey literature search was also undertaken, through the Google search engine, on 11 November 2019. Studies were analysed descriptively and synthesized qualitatively. Eighteen studies were identified that met inclusion criteria. All studies examined the incidence of suicidal behaviours. Twelve studies examined sociodemographic correlates, associations, or risk factors, and nine studies examined mental health. There was a high degree of variability regarding how both peripartum status and suicidal behaviours were defined. Few studies used data linkage to examine suicidal behaviours from a health services or social services perspective. The evidence base could benefit from conceptual clarity and standardization of constructs regarding suicidal behaviours in the peripartum period, to enable meaningful synthesis of results across studies. Data linkage can be used to improve understandings of risk factors and pathways. It can also be harnessed to examine both health and social services utilization, to inform coordinated multi-sectoral interventions and care pathways for women and their children.
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Parental death by external causes and risk of hospital-treated deliberate self-harm in bereaved offspring. Eur Child Adolesc Psychiatry 2021; 30:539-548. [PMID: 32318879 PMCID: PMC8041704 DOI: 10.1007/s00787-020-01534-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/08/2020] [Indexed: 10/25/2022]
Abstract
Previous studies have reported an increased risk of hospital-treated deliberate self-harm (DSH) in offspring who have lost a parent, but inconclusive findings regarding differences between loss from suicide and accidents. The present study aimed to investigate the association between parental death by external causes before age 18 and hospital-treated DSH, and potential differences between different accidents and suicide. This nested-case-control study was based on data from longitudinal Norwegian registers. Subjects comprised 12,526 people born between 1970 and 2003 who received acute somatic treatment because of DSH at hospitals and associated services between 2008 and 2013 (cases), and 222,362 controls matched for gender and date of birth with no recorded DSH treatment. Information concerning deceased parent's death and offspring's DSH treatment and socioeconomic data was merged. Data were analysed with conditional logistic regression. Results indicated that offspring who had lost a parent to suicide (OR 2.32, 95% CI 1.92-2.80) and death by accidents such as falls, poisoning, and drowning (OR 1.79, 95% CI 1.38-2.33) had a significantly increased risk of hospital-treated DSH compared to offspring who had not experienced such loss. Parental bereavement from transport accidents and other external causes were not associated with significantly increased risks. No differences were evident for different genders of deceased, ages at bereavement, or genders of bereaved. The improved identification of bereaved offspring at particular risk of hospital-treated DSH should be utilized to implement effective prevention and treatment programs in specialist healthcare aimed at the individuals at highest risk.
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15
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"It Changes Your Orbit": The Impact of Suicide and Traumatic Death on Adolescents as Experienced by Adolescents and Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249356. [PMID: 33327577 PMCID: PMC7765017 DOI: 10.3390/ijerph17249356] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/30/2020] [Accepted: 12/11/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Having someone close die through suicide or another form of traumatic death is a distressing event in the lives of adolescents, putting them at risk of grief and mental health ramifications. As most research in this field has been focused on intrapersonal grief reactions, this study aimed to broaden the perspective by exploring the impact of the death through an interpersonal lens. METHODS The study involved individual and group interviews with bereaved adolescents (n = 20) and parents of bereaved adolescents (n = 18), and thematic analysis of the data. RESULTS The analysis yielded three themes: (i) the death is a life-changing experience, (ii) the death differentiates you from your peers, and (iii) the death impacts on the family system. CONCLUSIONS The study revealed the devastating impact of the deaths on adolescents, their relationships with peers and the family system. Adolescents' grief must be understood within the context of their agency and their immediate social environment. The findings clearly indicate that support for bereaved adolescents should incorporate the familial context.
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16
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Syed S, Kingsbury M, Bennett K, Manion I, Colman I. Adolescents' knowledge of a peer's non-suicidal self-injury and own non-suicidal self-injury and suicidality. Acta Psychiatr Scand 2020; 142:366-373. [PMID: 32885408 DOI: 10.1111/acps.13229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Some research suggests that suicidal ideation and attempt among adolescents may be contagious - that is adolescents who are exposed to peers' suicidal behaviour are more likely to experience suicidal ideation or attempt suicide themselves. Less is known about the potential contagion effect of non-suicidal self-injury (NSSI). Our objective was to determine whether knowledge of a friend's NSSI is associated with adolescent's own non-suicidal self-injury and suicidal behaviours. METHODS Data from 1483 youth ages 14-17 years were obtained from the 2014 Ontario Child Health Study, a cross-sectional population-based survey of children and adolescents in Ontario, Canada. Logistic regression models were used to examine associations between knowledge of a friend's NSSI and adolescents' own self-reported self-injurious and suicidal behaviours. Interactions with gender, age group and presence of a mental disorder were investigated. RESULTS Knowledge of a friend's non-suicidal self-injury was significantly associated with the adolescent's own non-suicidal self-injury (OR = 2.03, 95% CI 1.05-3.90), suicidal ideation (OR = 3.08, 95% CI 1.50-6.30) and suicide attempt (OR = 2.87, 95% CI 1.20-6.87). CONCLUSION These findings suggest an apparent contagion effect for non-suicidal self-injury. Awareness of a friend's self-injurious behaviours is associated with an adolescent's own self-injury and suicidality. Interventions aimed at preventing NSSI and suicidality should consider prevention of possible contagion at the school and/or community level.
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Affiliation(s)
- S Syed
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - M Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - K Bennett
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics) and the Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - I Manion
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - I Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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17
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Hua P, Maple M, Hay K, Bugeja L. Theoretical frameworks informing the relationship between parental death and suicidal behaviour: A scoping review. Heliyon 2020; 6:e03911. [PMID: 32426539 PMCID: PMC7226651 DOI: 10.1016/j.heliyon.2020.e03911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/26/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background Exposure to parental death in childhood has been strongly associated with offspring suicide although few studies have applied theoretical models to conceptualise this relationship. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Reviews guidelines, we conducted a scoping review of primary studies that identified a theory/framework explaining the aetiology of suicidal behaviour in adulthood, following childhood exposure to external-cause parental death, including suicide. Results The search yielded 1598 articles. Following full-text screening, 23 studies were identified as meeting inclusion criteria. Data extraction was then completed and found that the studies collectively referenced nine theories. The specific theories identified covered a range of biopsychosocial frameworks and included attachment theory, familial transmission of suicide, conservation of resources framework, diathesis-stress model, social integration theory, socio-ecological model, social learning theory, critical period hypothesis or life course approach and the developmental model of antisocial behaviour. Limitations It was beyond the scope of this review to conduct rigorous testing and evaluation of the theories identified. Future research could extend on this study by developing criteria to assess the range of theories and frameworks on suicide exposure, as well as the studies providing evidence for these theories, in order to guide more advanced theory development as well as policies, programs and interventions. Conclusions Based on these theories, the authors proposed that using an integrated biopsychosocial model will provide a more comprehensive understanding of the diverse risk and protective factors for suicidal behaviour following parental death.
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Affiliation(s)
- Phuong Hua
- Department of Forensic Medicine, Monash University, VIC 3800 Australia
| | - Myfanwy Maple
- School of Health, University of New England, NSW 2351 Australia
| | - Kieran Hay
- School of Health, University of New England, NSW 2351 Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, VIC 3800 Australia.,School of Nursing and Midwifery, Monash University, VIC 3800 Australia
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18
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Hill NTM, Robinson J, Pirkis J, Andriessen K, Krysinska K, Payne A, Boland A, Clarke A, Milner A, Witt K, Krohn S, Lampit A. Association of suicidal behavior with exposure to suicide and suicide attempt: A systematic review and multilevel meta-analysis. PLoS Med 2020; 17:e1003074. [PMID: 32231381 PMCID: PMC7108695 DOI: 10.1371/journal.pmed.1003074] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Exposure to suicidal behavior may be associated with increased risk of suicide, suicide attempt, and suicidal ideation and is a significant public health problem. However, evidence to date has not reliably distinguished between exposure to suicide versus suicide attempt, nor whether the risk differs across suicide-related outcomes, which have markedly different public health implications. Our aim therefore was to quantitatively assess the independent risk associated with exposure to suicide and suicide attempt on suicide, suicide attempt, and suicidal ideation outcomes and to identify moderators of this risk using multilevel meta-analysis. METHODS AND FINDINGS We systematically searched MEDLINE, Embase, PsycINFO, CINAHL, ASSIA, Sociological Abstracts, IBSS, and Social Services Abstracts from inception to 19 November 2019. Eligible studies included comparative data on prior exposure to suicide, suicide attempt, or suicidal behavior (composite measure-suicide or suicide attempt) and the outcomes of suicide, suicide attempt, and suicidal ideation in relatives, friends, and acquaintances. Dichotomous events or odds ratios (ORs) of suicide, suicide attempt, and suicidal ideation were analyzed using multilevel meta-analyses to accommodate the non-independence of effect sizes. We assessed study quality using the National Heart, Lung, and Blood Institute quality assessment tool for observational studies. Thirty-four independent studies that presented 71 effect sizes (exposure to suicide: k = 42, from 22 independent studies; exposure to suicide attempt: k = 19, from 13 independent studies; exposure to suicidal behavior (composite): k = 10, from 5 independent studies) encompassing 13,923,029 individuals were eligible. Exposure to suicide was associated with increased odds of suicide (11 studies, N = 13,464,582; OR = 3.23, 95% CI = 2.32 to 4.51, P < 0.001) and suicide attempt (10 studies, N = 121,836; OR = 2.91, 95% CI = 2.01 to 4.23, P < 0.001). However, no evidence of an association was observed for suicidal ideation outcomes (2 studies, N = 43,354; OR = 1.85, 95% CI = 0.97 to 3.51, P = 0.06). Exposure to suicide attempt was associated with increased odds of suicide attempt (10 studies, N = 341,793; OR = 3.53, 95% CI = 2.63 to 4.73, P < 0.001), but not suicide death (3 studies, N = 723; OR = 1.64, 95% CI = 0.90 to 2.98, P = 0.11). By contrast, exposure to suicidal behavior (composite) was associated with increased odds of suicide (4 studies, N = 1,479; OR = 3.83, 95% CI = 2.38 to 6.17, P < 0.001) but not suicide attempt (1 study, N = 666; OR = 1.10, 95% CI = 0.69 to 1.76, P = 0.90), a finding that was inconsistent with the separate analyses of exposure to suicide and suicide attempt. Key limitations of this study include fair study quality and the possibility of unmeasured confounders influencing the findings. The review has been prospectively registered with PROSPERO (CRD42018104629). CONCLUSIONS The findings of this systematic review and meta-analysis indicate that prior exposure to suicide and prior exposure to suicide attempt in the general population are associated with increased odds of subsequent suicidal behavior, but these exposures do not incur uniform risk across the full range of suicide-related outcomes. Therefore, future studies should refrain from combining these exposures into single composite measures of exposure to suicidal behavior. Finally, future studies should consider designing interventions that target suicide-related outcomes in those exposed to suicide and that include efforts to mitigate the adverse effects of exposure to suicide attempt on subsequent suicide attempt outcomes.
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Affiliation(s)
- Nicole T. M. Hill
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Karolina Krysinska
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Amber Payne
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Northeastern University, Boston, Massachusetts, United States of America
| | - Alexandra Boland
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Alison Clarke
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Allison Milner
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Katrina Witt
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Stephan Krohn
- Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amit Lampit
- Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
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Abstract
Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.
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20
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Spillane A, Matvienko-Sikar K, Larkin C, Arensman E. How do people experience a family member's high-risk self-harm? An interpretative phenomenological analysis. Arch Suicide Res 2020; 24:280-302. [PMID: 30734665 DOI: 10.1080/13811118.2019.1574248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Few studies have explored the impact self-harm has on family members, with none specifically focusing on physical and psychosomatic responses following a family member's high-risk self-harm Therefore, this study aims to explore the health impact of experiencing a family member's high-risk self-harm. Participants represented family members of consecutive cases of self-harm, who were recruited from the Suicide Support and Information System - A Case-Control Study (SSIS-ACE). Qualitative interviews were conducted with 9 participants whose family member presented to a large tertiary hospital in Ireland with high-risk self-harm. Interpretative phenomenological analysis was conducted. Qualitative findings indicated 4 superordinate themes in relation to experiences following a family member's presentation to hospital following an episode of high-risk self-harm (1) implications for health and well-being; (2) process of meaning-making; (3) feelings of responsibility and (4) challenges with support network. Participants consistently experienced adverse health impacts including vomiting, hypertension, and depression. The findings imply that caring for their own and their family members' well-being, together with challenges with accessing health services underscores the importance of family members being proactively contacted by healthcare professionals to alleviate these detrimental health effects.
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21
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Landberg J, Danielsson A, Hemmingsson T. Fathers' alcohol use and suicidal behaviour in offspring during youth and young adulthood. Acta Psychiatr Scand 2019; 140:563-573. [PMID: 31487035 PMCID: PMC6899547 DOI: 10.1111/acps.13098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the association between various indicators of father's alcohol use and suicidal behaviour in offspring during youth and young adulthood. METHODS The study is based on a cohort of 68 910 Swedish citizens who were born between 1970 and 1985 and have fathers who participated in conscription for compulsory military training in 1969/70. Information on fathers' alcohol use was collected during conscription. Offspring was followed for suicide attempts or completed suicides (through linkage with national registers) from age 12 to end of follow-up in 2008. RESULTS After adjustment for confounders, the hazard ratio (HR) for offspring to fathers who were heavy drinkers was 1.4 (95% CI 1.02, 1.93) while the associations turned non-significant for offspring to fathers who often drank into intoxication, HR 1.14 (0.68, 1.90). The highest risk for suicidal behaviour was found for offspring to fathers who had been apprehended for drunkenness two times or more, or with an alcohol-related hospitalization, with adjusted HRs of 2.1 (1.4, 3,14) and 1.9 (1.27, 2,85) respectively. CONCLUSION Fathers' alcohol use is associated with increased risk of suicidal behaviour among offspring in youth and young adulthood.
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Affiliation(s)
- J. Landberg
- Department of Public Health SciencesStockholm UniversityStockholmSweden,Department of Clinical NeuroscienceKarolinska InstituteSolnaSweden
| | - A.‐K. Danielsson
- Department of Public Health SciencesKarolinska InstituteSolnaSweden
| | - T. Hemmingsson
- Department of Public Health SciencesStockholm UniversityStockholmSweden,Institute of Environmental MedicineKarolinska InstituteSolnaSweden
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22
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Hua P, Bugeja L, Maple M. A systematic review on the relationship between childhood exposure to external cause parental death, including suicide, on subsequent suicidal behaviour. J Affect Disord 2019; 257:723-734. [PMID: 31382125 DOI: 10.1016/j.jad.2019.07.082] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/19/2019] [Accepted: 07/29/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Exposure to parental death in childhood has been associated with offspring suicide risk, although the strength of this association is unclear. The primary aim of this systematic review was to synthesise primary studies on the relationship between childhood exposure to external cause parental death, including suicide, and subsequent suicidal behaviour in adulthood. The secondary objective was to compare suicide-related outcomes of exposure to parental suicide with the outcomes of exposure to other external cause parental deaths. METHODS A systematic review was conducted using guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ovid MEDLINE, Cochrane Library, Ovid PsycINFO, Web of Science, CINAHL and EMBASE were searched from January 2008 until November 2018. Two researchers independently screened the articles, performed data extraction and assessed quality of evidence using the Newcastle-Ottawa Scale. RESULTS Of the 618 studies identified, 26 were included for review. Only one study found no significant association between childhood exposure to suicide and increased suicide risk in adulthood. Four studies suggested the risk of suicidality in adulthood was greater for those exposed to parental suicide compared to other external cause deaths. LIMITATIONS The use of national registers in many studies did not allow for all variables of interest to be examined. Selective samples also limited the generalizability of findings. CONCLUSIONS A strong association between parental suicide and suicidal behaviour in adult offspring exists. Interventions for bereaved youth should consider the long-term effects of parental suicide and target individual and environmental-level risk factors for subsequent suicidality.
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Affiliation(s)
- Phuong Hua
- Department of Forensic Medicine, Monash University, VIC 3800, Australia.
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, VIC 3800, Australia; School of Nursing and Midwifery, Monash University, VIC 3800, Australia
| | - Myfanwy Maple
- School of Health, University of New England, NSW 2351, Australia
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23
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Ballard ED, Cui L, Vandeleur C, Castelao E, Zarate CA, Preisig M, Merikangas KR. Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults. JAMA Psychiatry 2019; 76:826-833. [PMID: 30916728 PMCID: PMC6583867 DOI: 10.1001/jamapsychiatry.2019.0248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Clarification of the joint influence of familial patterns of suicide attempts and comorbid mental disorders can enhance the understanding and prevention of suicide attempts. OBJECTIVE To investigate the familial patterns of suicide attempts and comorbid mental disorders and their associations in a 2-site family study of mood and anxiety disorders. DESIGN, SETTING, AND PARTICIPANTS Data were obtained from 2 parallel community-based family studies conducted in the United States (National Institute of Mental Health [NIMH] study) and in Lausanne, Switzerland (PsyCoLaus study), on the comorbidity of mood and anxiety disorders. The study sample comprised 1119 adult probands and 5355 first-degree relatives. Data were collected and analyzed from October 2004 to December 2016. MAIN OUTCOMES AND MEASURES Lifetime suicide attempt and mental disorders in first-degree relatives, obtained through direct interviews or family history reports. RESULTS The study included 1119 adult probands (675 female [60.3%] and a mean [SD] age of 50 [12.0] years) and 5355 first-degree relatives (2752 female [51.4%] and a mean [SD] age of 52 [1.5] years). Of these participants, 90 (8.0%) of 1119 probands and 199 (3.7%) of 5355 relatives had a lifetime history of suicide attempt. Those with such a history had higher rates of all mental disorders, a greater number of disorders, and statistically significantly poorer current and lifetime global functioning. After adjustment for age and sex, a statistically significant association between suicide attempts in probands and in relatives was found at the NIMH site (OR, 2.6; 95% CI, 1.5-4.7), at the Lausanne site (OR, 3.1; 95% CI, 1.6-6.0), and in the combined data (OR, 2.9; 95% CI, 1.9-4.5). All mood disorder subtypes and substance use disorders were statistically significantly associated with suicide attempts. The familial association between lifetime suicide attempts in probands and relatives was not statistically significant for the combined sample (OR, 1.6; 95% CI, 1.0-2.7) after adjustment for comorbid conditions in probands and relatives. Social anxiety disorder in probands was associated with suicide attempts in relatives (OR, 2.4; 95% CI, 1.7-3.5) after controlling for comorbid mood, anxiety, and substance use disorders. CONCLUSIONS AND RELEVANCE Familiality of suicide attempts appears to be explained by a history of mental disorders among those with suicide attempts; the novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts.
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Affiliation(s)
- Elizabeth D. Ballard
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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Goodday SM, Shuldiner J, Bondy S, Rhodes AE. Exposure to parental psychopathology and offspring's risk of suicide-related thoughts and behaviours: a systematic review. Epidemiol Psychiatr Sci 2019; 28:179-190. [PMID: 28748774 PMCID: PMC6998933 DOI: 10.1017/s2045796017000397] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/03/2017] [Indexed: 12/31/2022] Open
Abstract
AIMS The primary objective of this systematic review was to identify and synthesise analytic studies examining the association between exposure to parental psychopathology in childhood and the nature of subsequent suicide-related thoughts (SRT) and suicide-related behaviour (SRB) (severity of ideation, planned/unplanned attempts/lethality) and to describe the direction, and magnitude of associations. The secondary objective was to determine if the associations from the primary objective differ by the type(s) and timing of parental psychopathology, sex/gender of the parent and child and is mediated by child psychiatric symptoms and family functioning. METHODS A systematic review was conducted using guidelines from the PRISMA statement. MEDLINE, CINAHL, EMBASE, psycINFO, Web of Science and grey literature sources were searched by two reviewers to March, 2017. Studies were included if they examined any parental psychopathology (Diagnostic and Statistical Manual of Mental Disorders criteria or equivalent) or SRT or SRB and offspring SRT or SRB occurring from birth <25 years of age. RESULTS Out of 10 231 studies identified, 54 were included for review. Studies were clinically and methodologically heterogeneous with none at low risk of bias (ROB). Nine studies with moderate ROB indicated a significantly increased risk of offspring SRT, suicide attempts (SA) and suicide among those exposed to maternal SA and suicide in childhood or adolescence. In the remaining 45 studies with higher ROB this association persisted. Several studies (67%) did not confirm that the exposure occurred in the offspring's childhood or adolescence. Findings were suggestive of a mediating effect of offspring psychiatric symptoms, however, few studies examined mediation and effect modification of contextual variables. CONCLUSIONS Offspring exposed to maternal SA are at an increased risk of these same behaviours early in life. Prospective attention to the types and timing of maternal and paternal psychopathology and the intermediate pathways to offspring SRT and SRB onset is needed and could have implications for informing modifiable targets for early intervention and prevention.
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Affiliation(s)
- S. M. Goodday
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - J. Shuldiner
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - S. Bondy
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - A. E. Rhodes
- Department of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- McMaster University, The Offord Centre for Child Studies, Hamilton, Ontario, Canada
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Kenneally LB, Szűcs A, Szántó K, Dombrovski AY. Familial and social transmission of suicidal behavior in older adults. J Affect Disord 2019; 245:589-596. [PMID: 30445383 PMCID: PMC6351150 DOI: 10.1016/j.jad.2018.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/29/2018] [Accepted: 11/03/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Both biological and social mechanisms have been implicated in the transmission of suicidal behavior in younger and middle-aged adults. Yet, while suicide rates rise with age, it is not clear whether such mechanisms operate in late life. Thus, we looked for evidence of social and familial suicidal transmission in elderly with late- vs. early-onset suicidal behavior by examining exposure to suicidal behavior within biological relatives and broader social networks. METHOD Participants were 356 adults, aged 50 or older (mean: 67), divided into five groups: early-onset suicide attempters (first lifetime attempt before age 60), late-onset attempters, suicide ideators (without attempt history), depressed non-suicidal controls, and non-psychiatric controls. History of suicidal behavior in one's biological relatives and friends/unrelated kin was assessed via clinical interview, and group differences were examined via generalized linear mixed-effects models. RESULTS There was a main effect of group (χ24 = 18.38, p < 0.001) such that familial or social exposure to suicidal behavior was more prevalent in early- than late-onset attempters. Late-onset attempters' exposure was similar to non-suicidal groups'. However, there was no significant group by relationship interaction, indicating that suicidal behavior was not significantly more prominent among the biological relatives of either attempter group. LIMITATIONS Participants' report of exposure is subject to awareness and recall biases. CONCLUSION Suicidal clustering in biological relatives and friends/unrelated kin is associated with early-, but not late-onset suicidal behavior in older adults. Suicidal transmission in older adults follows a pattern of familial and social clustering suggestive of social transmission.
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Affiliation(s)
- Laura B. Kenneally
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, United States
| | - Anna Szűcs
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, United States,University of Geneva, Department of Psychiatry, Geneva, Switzerland
| | - Katalin Szántó
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Alexandre Y. Dombrovski
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, United States
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Fanelli G, Serretti A. The influence of the serotonin transporter gene 5-HTTLPR polymorphism on suicidal behaviors: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:375-387. [PMID: 30125622 DOI: 10.1016/j.pnpbp.2018.08.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/31/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
Suicidal Behavior (SB) is the second leading cause of death among youths worldwide and the tenth among all age groups. Inherited genetic differences have a role in suicidality with heritability ranging from 30 to 55%. The SLC6A4 5-HTTLPR gene variant has been largely investigated for association with SB, with controversial results. In this work, we sought to determine whether the results of previous meta-analyses were confirmed or modified subsequent to the inclusion of more recent literature data. An electronic literature search was performed to identify relevant studies published until July 2018. Data were analysed through RevMan v5.3. Subgroup and sensitivity meta-analyses were performed considering different SB sub-phenotypes, ethnicity, gender and psychiatric diagnostic categories. Our literature search yielded 1186 articles; among these, we identified 45 pertinent case-control studies (15,341 subjects). No association was found between low-expressing alleles or genotypes (S + LG alleles or S' carrier genotypes) and SB in the primary analyses. However, low-expressing alleles (S + LG) were associated with an increased risk of Violent Suicide Attempt (OR = 1.44, C.I. 1.17-1.78, p = .0007). An effect of the same alleles on SB was found in a subpopulation of substance abusers, but this result was not confirmed after the exclusion of healthy subjects from the control group. The other sensitivity meta-analyses did not show any significant effect. Our findings contribute to clarify the conflicting previous evidence by suggesting an association between the 5-HTTLPR and Violent SB. Nonetheless, many other modulators, including environmental factors and epigenetic mechanisms may act to further increase the level of complexity.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
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27
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Erlangsen A, Qin P, Mittendorfer-Rutz E. Studies of Suicidal Behavior Using National Registers. CRISIS 2018; 39:153-158. [PMID: 29792362 DOI: 10.1027/0227-5910/a000552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Annette Erlangsen
- 1 Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Hellerup, Denmark.,2 Department of Mental Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,3 Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Ping Qin
- 4 National Center for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ellenor Mittendorfer-Rutz
- 5 Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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28
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Welch RJ, Rao R, Gordon PS, Say EAT, Shields CL. Optical Coherence Tomography of Small Retinoblastoma. Asia Pac J Ophthalmol (Phila) 2018; 7:301-306. [PMID: 29984562 DOI: 10.22608/apo.2018189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate hand-held optical coherence tomography (HH-OCT) characteristics of small (<1 mm thickness) retinoblastoma. DESIGN Retrospective observational case series. METHODS Patient and tumor data were extracted from the medical record and analyzed along with HH-OCT scans. Determination of tumor layer of origin was performed using a layer-by-layer analysis of HH-OCT data and specific HH-OCT-related features were described. RESULTS There were 20 sub-millimeter retinoblastomas from 16 eyes of 15 patients. Mean largest tumor basal diameter by HH-OCT was 2.2 mm (median, 1.9; range, 0.7-4.1 mm), and mean tumor thickness was 468 μm (median, 441; range, 151-998 μm). In all cases, the retinoblastoma caused discontinuity or disruption of the inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), and external limiting membrane (ELM) layers (20/20, 100%). Tumor origin was in the INL in 19/20 (95%) and equivocal (INL vs ONL) in 1/20 (5%). Intratumoral microcalcification was present in 14/20 tumors (70%). There were 2 characteristic findings (signs) on HH-OCT including the INL "fish tail" sign with splaying of the INL at the tumor margin (19/20, 95%) and the ONL "shark fin" sign with folding of the ONL and OPL, conforming to the lateral tumor margins (15/20, 75%). Both signs were concurrently present in 15 tumors (15/20, 75%). CONCLUSIONS HH-OCT demonstrated that sub-millimeter retinoblastoma seems to originate from the INL, with tumor base and thickness growth progressing in a linear relationship. Characteristic HH-OCT findings included intratumoral microcalcification, INL "fish tail" sign, and ONL "shark fin" sign.
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Affiliation(s)
- R Joel Welch
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Raksha Rao
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Phillip S Gordon
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Emil Anthony T Say
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
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Systematic Literature Review of Attempted Suicide and Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050937. [PMID: 29738447 PMCID: PMC5981976 DOI: 10.3390/ijerph15050937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
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Predictors of Suicide Behavior Relapse in Pediatric Population. THE SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E6. [PMID: 29576038 DOI: 10.1017/sjp.2018.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.
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Andriessen K, Lobb E, Mowll J, Dudley M, Draper B, Mitchell PB. Help-seeking experiences of bereaved adolescents: A qualitative study. DEATH STUDIES 2018; 43:1-8. [PMID: 29393826 DOI: 10.1080/07481187.2018.1426657] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much-needed auxiliary. Parental encouragement is important in accessing adequate professional help.
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Affiliation(s)
- Karl Andriessen
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Elizabeth Lobb
- b Calvary Health Care , Kogarah , NSW , Australia
- c Cunningham Centre for Palliative Care , Darlinghurst , NSW , Australia
- d School of Medicine , University of Notre Dame , Darlinghurst , NSW , Australia
| | - Jane Mowll
- e School of Social Sciences , University of New South Wales , Sydney , NSW , Australia
| | - Michael Dudley
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Brian Draper
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
| | - Philip B Mitchell
- a School of Psychiatry , University of New South Wales , Randwick , NSW , Australia
- f Black Dog Institute , Randwick , NSW , Australia
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32
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Spillane A, Matvienko-Sikar K, Larkin C, Corcoran P, Arensman E. What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland. BMJ Open 2018; 8:e019472. [PMID: 29331974 PMCID: PMC5781012 DOI: 10.1136/bmjopen-2017-019472] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Research focussing on the impact of suicide bereavement on family members' physical and psychological health is scarce. The aim of this study was to examine how family members have been physically and psychologically affected following suicide bereavement. A secondary objective of the study was to describe the needs of family members bereaved by suicide. DESIGN A mixed-methods study was conducted, using qualitative semistructured interviews and additional quantitative self-report measures of depression, anxiety and stress (DASS-21). SETTING Consecutive suicide cases and next-of-kin were identified by examining coroner's records in Cork City and County, Ireland from October 2014 to May 2016. PARTICIPANTS Eighteen family members bereaved by suicide took part in a qualitative interview. They were recruited from the Suicide Support and Information System: A Case-Control Study (SSIS-ACE), where family members bereaved by suicide (n=33) completed structured measures of their well-being. RESULTS Qualitative findings indicated three superordinate themes in relation to experiences following suicide bereavement: (1) co-occurrence of grief and health reactions; (2) disparity in supports after suicide and (3) reconstructing life after deceased's suicide. Initial feelings of guilt, blame, shame and anger often manifested in enduring physical, psychological and psychosomatic difficulties. Support needs were diverse and were often related to the availability or absence of informal support by family or friends. Quantitative results indicated that the proportion of respondents above the DASS-21 cut-offs respectively were 24% for depression, 18% for anxiety and 27% for stress. CONCLUSIONS Healthcare professionals' awareness of the adverse physical and psychosomatic health difficulties experienced by family members bereaved by suicide is essential. Proactively facilitating support for this group could help to reduce the negative health sequelae. The effects of suicide bereavement are wide-ranging, including high levels of stress, depression, anxiety and physical health difficulties.
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Affiliation(s)
- Ailbhe Spillane
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | | | - Celine Larkin
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Paul Corcoran
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
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33
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Lee KY, Li CY, Chang KC, Lu TH, Chen YY. Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People. CRISIS 2018; 39:27-36. [DOI: 10.1027/0227-5910/a000468] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.
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Affiliation(s)
- Kuan-Ying Lee
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Kun-Chia Chang
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan
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34
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Andriessen K, Rahman B, Draper B, Dudley M, Mitchell PB. Prevalence of exposure to suicide: A meta-analysis of population-based studies. J Psychiatr Res 2017; 88:113-120. [PMID: 28199930 DOI: 10.1016/j.jpsychires.2017.01.017] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/10/2017] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
Abstract
Those exposed to suicide are at increased risk of adverse outcomes including mental illness, impaired social functioning, and fatal and non-fatal suicidal behavior. However, it is unclear how many people are exposed to suicide in the general community. This first meta-analysis of population-based studies aimed to provide pooled estimates of past-year and lifetime prevalence of exposure to suicide among family, friends/peers, and all relationships. In addition, the study examined prevalence of exposure to suicide by age group: adolescents and adults. Systematic searches of the literature in Embase, Medline and PsycINFO identified eighteen studies that were included in the analysis. Pooled past-year prevalence was 4.31% (CI: 2.50 to 6.58) and life-time prevalence 21.83% (CI: 16.32 to 27.90). Both past-year and lifetime prevalences of exposure to suicide among friends and peers were significantly higher than the prevalence of exposure within families; there were no differences in the prevalence of exposure to suicide between adolescents and adults. Heterogeneity was highly significant. Future research should be conducted with large national representative samples and use standardised assessment instruments. Given the increased risks of adverse outcomes among those exposed to suicide, the high rate of exposure to suicide reported here has important ramifications for public health and mental health service delivery.
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Affiliation(s)
- Karl Andriessen
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick 2031, NSW, Australia
| | - Bayzidur Rahman
- School of Public Health and Community Medicine, University of New South Wales, Australia
| | - Brian Draper
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick 2031, NSW, Australia
| | - Michael Dudley
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick 2031, NSW, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick 2031, NSW, Australia.
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35
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Gould TD, Georgiou P, Brenner LA, Brundin L, Can A, Courtet P, Donaldson ZR, Dwivedi Y, Guillaume S, Gottesman II, Kanekar S, Lowry CA, Renshaw PF, Rujescu D, Smith EG, Turecki G, Zanos P, Zarate CA, Zunszain PA, Postolache TT. Animal models to improve our understanding and treatment of suicidal behavior. Transl Psychiatry 2017; 7:e1092. [PMID: 28398339 PMCID: PMC5416692 DOI: 10.1038/tp.2017.50] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 01/16/2017] [Accepted: 02/01/2017] [Indexed: 02/08/2023] Open
Abstract
Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes. Animal models are similarly a critical resource to help delineate treatment targets and pharmacological means to improve our ability to manage the risk of suicide. In particular, certain pathophysiological pathways to suicidal behavior, including stress and hypothalamic-pituitary-adrenal axis dysfunction, neurotransmitter system abnormalities, endocrine and neuroimmune changes, aggression, impulsivity and decision-making deficits, as well as the role of critical interactions between genetic and epigenetic factors, development and environmental risk factors can be modeled in laboratory animals. We broadly describe human biological findings, as well as protective effects of medications such as lithium, clozapine, and ketamine associated with modifying risk of engaging in suicidal behavior that are readily translatable to animal models. Endophenotypes of suicidal behavior, studied in animal models, are further useful for moving observed associations with harmful environmental factors (for example, childhood adversity, mechanical trauma aeroallergens, pathogens, inflammation triggers) from association to causation, and developing preventative strategies. Further study in animals will contribute to a more informed, comprehensive, accelerated and ultimately impactful suicide research portfolio.
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Affiliation(s)
- T D Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P Georgiou
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L A Brenner
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - A Can
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Psychology, Notre Dame of Maryland University, Baltimore, MD, USA
| | - P Courtet
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - Z R Donaldson
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology, University of Colorado, Boulder, Boulder, CO, USA
- Department of Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Y Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Guillaume
- Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Montpellier, France
- Université Montpellier, Inserm U1061, Montpellier, France
| | - I I Gottesman
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - S Kanekar
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - C A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - P F Renshaw
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - D Rujescu
- Department of Psychiatry, University of Halle-Wittenberg, Halle, Germany
| | - E G Smith
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - P Zanos
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - P A Zunszain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - T T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Denver, CO, USA
- Military and Veteran Microbiome Consortium for Research and Education, U.S. Department of Veterans Affairs, Washington, DC, USA
- VISN 5 Mental Illness Research Education and Clinical Center, Baltimore MD, USA
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Quigley J, Rasmussen S, McAlaney J. The Associations Between Children's and Adolescents' Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review. Arch Suicide Res 2017; 21:185-236. [PMID: 27267251 DOI: 10.1080/13811118.2016.1193075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Social influences-including the suicidal and self-harming behaviors of others-have been highlighted as a risk factor for suicidal and self-harming behavior in young people, but synthesis of the evidence is lacking. A systematic review of 86 relevant papers was conducted. Considerable published evidence was obtained for positive associations between young people's suicidal and self-harming behavior and that of people they know, with those reporting knowing people who had engaged in suicidal or self-harming behaviors more likely to report engaging in similar behaviors themselves. Findings are discussed in relation to a number of methodological and measurement issues-including the role of normative perceptions-and implications for the prevention of suicidal and self-harming behavior are considered.
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Mok PL, Pedersen CB, Springate D, Astrup A, Kapur N, Antonsen S, Mors O, Webb RT. Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study. JAMA Psychiatry 2016; 73:1015-1022. [PMID: 27580483 PMCID: PMC5079483 DOI: 10.1001/jamapsychiatry.2016.1728] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Self-directed and interpersonal violence share some common risk factors such as a parental history of mental illness. However, relationships between the full spectrum of parental psychiatric disease and these 2 related outcomes are unclear. OBJECTIVE To examine associations between the full spectrum of parental psychiatric disease and risks of attempted suicide and violent offending among offspring. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study of all persons born in Denmark 1967 through 1997, followed up from their 15th birthday until occurrence of adverse outcome or December 31, 2012, whichever came first. EXPOSURES Array of parental psychiatric disorders and parental suicide attempt, delineated from records of secondary care treatments. MAIN OUTCOMES AND MEASURES Using survival analyses techniques, incidence rate ratios were estimated for offspring suicide attempt and violent offending. RESULTS We examined 1 743 525 cohort members (48.7% female; total follow-up, 27.2 million person-years). Risks for offspring suicide attempt and violent offending were elevated across virtually the full spectrum of parental psychiatric disease. Incidence rate ratios were the most elevated for parental diagnoses of antisocial personality disorder (suicide attempt, 3.96; 95% CI, 3.72-4.21; violent offending, 3.62; 95% CI, 3.41-3.84) and cannabis misuse (suicide attempt, 3.57; 95% CI, 3.25-3.92; violent offending, 4.05; 95% CI, 3.72-4.39), and for parental suicide attempt (suicide attempt, 3.42; 95% CI, 3.29-3.55; violent offending, 3.31; 95% CI, 3.19-3.44). Parental mood disorders (and bipolar disorder in particular) conferred more modest risk increases. A history of mental illness or suicide attempt in both parents was associated with double the risks compared with having just 1 affected parent. Associations between parental psychiatric disease and offspring violent offending were stronger for female than for male offspring, whereas little sex difference in risk was found for offspring suicide attempt. CONCLUSIONS AND RELEVANCE The similarities in risk patterns observed between the 2 outcomes may evidence a shared etiology. Early interventions to tackle parental mental disorders may be beneficial to both parents and children.
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Affiliation(s)
- Pearl L.H. Mok
- Centre for Mental Health and Safety, University of Manchester, Manchester, England
| | - Carsten Bøcker Pedersen
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - David Springate
- Institute of Population Health, University of Manchester, Manchester, England
| | - Aske Astrup
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Nav Kapur
- Centre for Mental Health and Safety, University of Manchester, Manchester, England
| | - Sussie Antonsen
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Roger T. Webb
- Centre for Mental Health and Safety, University of Manchester, Manchester, England
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Beden O, Senol E, Atay S, Ak H, Altintoprak AE, Kiyan GS, Petin B, Yaman U, Aydin HH. TPH1 A218 allele is associated with suicidal behavior in Turkish population. Leg Med (Tokyo) 2016; 21:15-8. [DOI: 10.1016/j.legalmed.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/08/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
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Geulayov G, Metcalfe C, Gunnell D. Parental suicide attempt and offspring educational attainment during adolescence in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Psychol Med 2016; 46:2097-2107. [PMID: 27063954 DOI: 10.1017/s0033291716000556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Few studies have investigated the impact of parental suicide attempt (SA) on offspring outcomes other than mental health. We investigated the association of parental SA with offspring educational attainment in the Avon Longitudinal Study of Parents and Children (ALSPAC). METHOD Parental SA was prospectively recorded from pregnancy until the study children were 11 years old. National school test results (ages 11-16 years) were obtained by record linkage. Multilevel regression models quantified the association between parental SA and offspring outcomes. RESULTS Data were available for 6667 mother-child and 3054 father-child pairs. Adolescents whose mothers had attempted suicide were less likely than their peers to achieve the expected educational level by age 14 years [adjusted odds ratio (aOR) 0.63, 95% confidence interval (CI) 0.41-0.95] in models controlling for relevant confounders, including parental education and depression. At age 16 years, adolescents whose mothers had attempted suicide were less likely to obtain the expected educational level (five or more qualifications at grade A*-C) (aOR 0.66, 95% CI 0.43-1.00) in models controlling for relevant confounders and parental education; however, after additionally controlling for maternal depression the results were consistent with chance (aOR 0.74, 95% CI 0.48-1.13). Findings in relation to paternal SA were consistent with those of maternal SA but power was limited due to lower response rate amongst fathers. CONCLUSIONS Maternal SA was associated with diminished educational performance at age 14 years. Educational attainment during adolescence can have substantial effect on future opportunities and well-being and these offspring may benefit from interventions.
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Affiliation(s)
- G Geulayov
- School of Social and Community Medicine,University of Bristol,Bristol,UK
| | - C Metcalfe
- School of Social and Community Medicine,University of Bristol,Bristol,UK
| | - D Gunnell
- School of Social and Community Medicine,University of Bristol,Bristol,UK
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Hammerton G, Zammit S, Thapar A, Collishaw S. Explaining risk for suicidal ideation in adolescent offspring of mothers with depression. Psychol Med 2016; 46:265-275. [PMID: 26303275 PMCID: PMC4682478 DOI: 10.1017/s0033291715001671] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/28/2015] [Accepted: 08/02/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is well-established that offspring of depressed mothers are at increased risk for suicidal ideation. However, pathways involved in the transmission of risk for suicidal ideation from depressed mothers to offspring are poorly understood. The aim of this study was to examine the contribution of potential mediators of this association, including maternal suicide attempt, offspring psychiatric disorder and the parent-child relationship. METHOD Data were utilized from a population-based birth cohort (ALSPAC). Three distinct classes of maternal depression symptoms across the first 11 years of the child's life had already been identified (minimal, moderate, chronic-severe). Offspring suicidal ideation was assessed at age 16 years. Data were analysed using structural equation modelling. RESULTS There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms compared to offspring of mothers with minimal symptoms (odds ratio 3.04, 95% confidence interval 2.19-4.21). The majority of this association was explained through maternal suicide attempt and offspring psychiatric disorder. There was also evidence for an independent indirect effect via the parent-child relationship in middle childhood. There was no longer evidence of a direct effect of maternal depression on offspring suicidal ideation after accounting for all three mediators. The pattern of results was similar when examining mechanisms for maternal moderate depression symptoms. CONCLUSIONS Findings highlight that suicide prevention efforts in offspring of depressed mothers should be particularly targeted at both offspring with a psychiatric disorder and offspring whose mothers have made a suicide attempt. Interventions aimed at improving the parent-child relationship may also be beneficial.
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Affiliation(s)
- G. Hammerton
- Institute of Psychological Medicine and Clinical
Neurosciences, Cardiff University,
Cardiff, UK
| | - S. Zammit
- Institute of Psychological Medicine and Clinical
Neurosciences, Cardiff University,
Cardiff, UK
- Centre for Academic Mental Health,
University of Bristol, Bristol,
UK
| | - A. Thapar
- Institute of Psychological Medicine and Clinical
Neurosciences, Cardiff University,
Cardiff, UK
| | - S. Collishaw
- Institute of Psychological Medicine and Clinical
Neurosciences, Cardiff University,
Cardiff, UK
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Andriessen K, Draper B, Dudley M, Mitchell PB. Pre- and postloss features of adolescent suicide bereavement: A systematic review. DEATH STUDIES 2015; 40:229-246. [PMID: 26678059 DOI: 10.1080/07481187.2015.1128497] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite increasing clinical and research interest in suicide bereavement the impact of suicide on adolescents is still poorly understood. This systematic review aims to disentangle pre- and postloss features that affect response to grief in this age group. The literature was analyzed after a systematic search and hand-check of retrieved articles. The impact of suicide is affected by (a) preloss features related to personal/family history of mental health, family life, suicidal behavior, and type and emotional closeness of relationship; and (b) postloss issues such as quality of remaining relationships. Future research and bereavement support should consider these broader contexts.
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Affiliation(s)
- Karl Andriessen
- a School of Psychiatry , University of New South Wales , Randwick , New South Wales , Australia
| | - Brian Draper
- a School of Psychiatry , University of New South Wales , Randwick , New South Wales , Australia
| | - Michael Dudley
- a School of Psychiatry , University of New South Wales , Randwick , New South Wales , Australia
| | - Philip B Mitchell
- a School of Psychiatry , University of New South Wales , Randwick , New South Wales , Australia
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ANDRIESSEN K, VIDETIC-PASKA A. Genetic Vulnerability as a Distal Risk Factor for Suicidal Behaviour: Historical Perspective and Current Knowledge. Zdr Varst 2015; 54:238-51. [PMID: 27646732 PMCID: PMC4820161 DOI: 10.1515/sjph-2015-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/17/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Suicide is a multidimensional problem. Observations of family history of suicide suggest the existence of a genetic vulnerability to suicidal behaviour. AIM Starting with a historical perspective, the article reviews current knowledge of a genetic vulnerability to suicidal behaviour, distinct from the genetic vulnerability to psychiatric disorders, focused on clinical and population-based studies, and findings from recent molecular genetics association studies. METHOD The review includes peer-reviewed research articles and review papers from the professional literature in English language, retrieved from PubMed/Medline and PsycINFO. RESULTS The research literature confirms a existence of a genetic vulnerability to suicidal behaviour. Even though the results of individual studies are difficult to compare, genetic influences could explain up to half of the variance of the occurrence of suicide. CONCLUSION Genetic vulnerability could be a distal risk factor for suicide, which helps us to understand the occurrence of suicide among vulnerable people. Ethical implications of such vulnerability are highlighted.
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Affiliation(s)
- Karl ANDRIESSEN
- University of New South Wales, School of Psychiatry, Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia
| | - Alja VIDETIC-PASKA
- University of Ljubljana, Faculty of Medicine, Institute of Biochemistry, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Hammerton G, Mahedy L, Mars B, Harold GT, Thapar A, Zammit S, Collishaw S. Association between Maternal Depression Symptoms across the First Eleven Years of Their Child's Life and Subsequent Offspring Suicidal Ideation. PLoS One 2015; 10:e0131885. [PMID: 26151929 PMCID: PMC4495034 DOI: 10.1371/journal.pone.0131885] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/08/2015] [Indexed: 11/19/2022] Open
Abstract
Depression is common, especially in women of child-bearing age; prevalence estimates for this group range from 8% to 12%, and there is robust evidence that maternal depression is associated with mental health problems in offspring. Suicidal behaviour is a growing concern amongst young people and those exposed to maternal depression are likely to be especially at high risk. The aim of this study was to utilise a large, prospective population cohort to examine the relationship between depression symptom trajectories in mothers over the first eleven years of their child’s life and subsequent adolescent suicidal ideation. An additional aim was to test if associations were explained by maternal suicide attempt and offspring depressive disorder. Data were utilised from a population-based birth cohort: the Avon Longitudinal Study of Parents and Children. Maternal depression symptoms were assessed repeatedly from pregnancy to child age 11 years. Offspring suicidal ideation was assessed at age 16 years. Using multiple imputation, data for 10,559 families were analysed. Using latent class growth analysis, five distinct classes of maternal depression symptoms were identified (minimal, mild, increasing, sub-threshold, chronic-severe). The prevalence of past-year suicidal ideation at age 16 years was 15% (95% CI: 14-17%). Compared to offspring of mothers with minimal symptoms, the greatest risk of suicidal ideation was found for offspring of mothers with chronic-severe symptoms [OR 3.04 (95% CI 2.19, 4.21)], with evidence for smaller increases in risk of suicidal ideation in offspring of mothers with sub-threshold, increasing and mild symptoms. These associations were not fully accounted for by maternal suicide attempt or offspring depression diagnosis. Twenty-six percent of non-depressed offspring of mothers with chronic-severe depression symptoms reported suicidal ideation. Risk for suicidal ideation should be considered in young people whose mothers have a history of sustained high levels of depression symptoms, even when the offspring themselves do not have a depression diagnosis.
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Affiliation(s)
- Gemma Hammerton
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
- * E-mail:
| | - Liam Mahedy
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Becky Mars
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
| | - Gordon T. Harold
- Andrew and Virginia Rudd Centre for Adoption Research and Practice, School of Psychology, University of Sussex, Sussex, United Kingdom
- International Center for Research in Human Development, Tomsk State University, Tomsk, Tomsk Oblast, Russia
| | - Anita Thapar
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Stanley Zammit
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
| | - Stephan Collishaw
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
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Lachal J, Orri M, Sibeoni J, Moro MR, Revah-Levy A. Metasynthesis of youth suicidal behaviours: perspectives of youth, parents, and health care professionals. PLoS One 2015; 10:e0127359. [PMID: 26001066 PMCID: PMC4441448 DOI: 10.1371/journal.pone.0127359] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 04/13/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Youth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group. METHODS AND FINDINGS This systematic review of qualitative studies--Medline, PsycInfo, Embase, CINAHL, and SSCI from 1990 to 2014--concerning suicide attempts by young people used thematic synthesis to develop categories inductively from the themes identified in the studies. The synthesis included 44 studies from 16 countries: 31 interviewed the youth, 7 their parents, and 6 the healthcare professionals. The results are organised around three superordinate themes: the individual experience, that is, the individual burden and suffering related to suicide attempts in all three groups; the relational experience, which describes the importance of relationships with others at all stages of the process of suicidal behaviour; and the social and cultural experience, or how the group and society accept or reject young people in distress and their families and how that affects the suicidal process and its management. CONCLUSION The violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences.
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Affiliation(s)
- Jonathan Lachal
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- INSERM, U1178, Paris, France
| | - Massimiliano Orri
- INSERM, U1178, Paris, France
- Université Paris Sud-Paris 11, Paris, France
| | - Jordan Sibeoni
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- INSERM, U1178, Paris, France
| | - Marie Rose Moro
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- INSERM, U1178, Paris, France
| | - Anne Revah-Levy
- INSERM, U1178, Paris, France
- Argenteuil Hospital Centre, Centre de Soins Psychothérapeutiques de Transition pour Adolescents, Argenteuil, France
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Pathways to suicide-related behavior in offspring of mothers with depression: the role of offspring psychopathology. J Am Acad Child Adolesc Psychiatry 2015; 54:385-93. [PMID: 25901775 PMCID: PMC4411216 DOI: 10.1016/j.jaac.2015.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 02/02/2015] [Accepted: 02/13/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Offspring of mothers with depression are a high-risk group for the development of suicide-related behavior. These offspring are therefore a priority for preventive interventions; however, pathways contributing to risk, including specific aspects of offspring psychopathology, remain unclear. The aim of this study was to examine whether offspring symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), disruptive behavior disorder (DBD), attention-deficit/hyperactivity disorder (ADHD), and alcohol abuse independently mediate the association between maternal depression and offspring suicide-related behavior. METHOD Data were used from a population-based birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Three distinct classes of depression symptoms across the mothers' first 11 years of their child's life were identified (minimal, moderate, chronic-severe). Offspring psychopathology was assessed at age 15 years and suicide-related behavior at age 16 years. Data were analyzed using structural equation modeling. RESULTS There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms in comparison to offspring of mothers with minimal symptoms (odds ratio = 3.04, 95% CI = 2.19, 4.21). This association was independently mediated by offspring MDD, GAD, and DBD symptoms. The same mechanisms were found for offspring of mothers with moderate depression symptoms over time. Results were similar for offspring suicide attempt except for additional evidence of an indirect effect through offspring ADHD symptoms. CONCLUSION Findings highlight that suicide prevention efforts in offspring of mothers with depression should not only be targeted at offspring with MDD; it is also important to consider offspring with other forms of psychopathology.
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Cheng CCJ, Yen WJ, Chang WT, Wu KCC, Ko MC, Li CY. Risk of adolescent offspring's completed suicide increases with prior history of their same-sex parents' death by suicide. Psychol Med 2014; 44:1845-1854. [PMID: 24063418 DOI: 10.1017/s0033291713002298] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND To investigate the risk of completed suicide in offspring during adolescence in relation to prior history of the same-sex parent's death by suicide and other causes. METHOD A total of 500 adolescents who died by suicide at age 15-19 years between 1997 and 2007 were identified from the Taiwan Mortality Registration (TMR). For each case, 30 age- and time-matched controls were selected randomly from all adolescents registered in the Taiwan Birth Registry (TBR). A multivariate conditional logistic regression model was used to assess the risk of adolescent completed suicide in relation to their same-sex parent. RESULTS Adolescent suicide risk was positively associated with both paternal [odds ratio (OR) 5.38, 95% confidence interval (CI) 2.17-13.33] and maternal suicide (OR 6.59, 95% CI 1.82-23.91). The corresponding risk estimates associated with paternal and maternal deaths from non-suicidal causes were much lower, at 1.88 and 1.94 respectively. The risk of suicide in male adolescents was significantly associated with prior history of paternal death by suicide (OR 8.23, 95% CI 2.96-22.90) but not of maternal death by suicide (OR 3.50, 95% CI 0.41-30.13). On the other contrary, the risk of suicidal death in female adolescents was significantly associated with prior history of maternal suicide (OR 9.71, 95% CI 1.89-49.94) but not of paternal suicide (OR 2.42, 95% CI 0.30-19.57). However, these differences did not reach statistical significance. CONCLUSIONS Although limited by sample size, our study indicates that adolescent offspring suicidal death is associated with prior history of their same-sex parent's death by suicide.
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Affiliation(s)
- C-C J Cheng
- Department of Public Health, College of Medicine,Fu-Jen Catholic University,New Taipei City,Taiwan
| | - W-J Yen
- College of Nursing,Chung Shan Medical University,Taichung City,Taiwan
| | - W-T Chang
- Department of Health Care Management,National Taipei University of Nursing and Health Sciences,Taipei,Taiwan
| | - K C-C Wu
- Department of Social Medicine, School of Medicine, College of Medicine,National Taiwan University,Taipei,Taiwan
| | - M-C Ko
- Department of Health Care Management,National Taipei University of Nursing and Health Sciences,Taipei,Taiwan
| | - C-Y Li
- Department of Public Health, College of Medicine,National Cheng Kung University,Tainan,Taiwan
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Parental suicide attempt and offspring self-harm and suicidal thoughts: Results from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. J Am Acad Child Adolesc Psychiatry 2014; 53:509-17.e2. [PMID: 24745951 DOI: 10.1016/j.jaac.2013.12.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 12/18/2013] [Accepted: 01/02/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Parental suicidal behavior is associated with offspring's risk of suicidal behavior. However, much of the available evidence is from population registers or clinical samples. We investigated the associations of self-reported parental suicide attempt (SA) with offspring self-harm and suicidal thoughts in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort. METHOD Parental SA was self-reported on 10 occasions from pregnancy until their child was 11 years of age. Offspring self-reported lifetime self-harm, with and without suicidal intent, suicidal thoughts, and suicide plans, at age 16 to 17 years. Multivariable regression models quantified the association between parental SA and offspring outcomes controlling for confounders. RESULTS Data were available for 4,396 mother-child and 2,541 father-child pairs. Adjusting for confounders including parental depression, maternal SA was associated with a 3-fold increased risk of self-harm with suicidal intent in their children (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.43-6.07) but not with self-harm without suicidal intent (aOR = 0.83, 95% CI = 0.35-1.99). Children whose mother attempted suicide were more likely to report suicidal thoughts and plans (aOR = 5.04, 95% CI = 2.24-11.36; aOR = 2.17, 95% CI = 1.07-4.38, respectively). Findings in relation to paternal SA were somewhat weaker and not significant. CONCLUSIONS Maternal SA increased their offspring's risk of self-harm with suicidal intent and of suicidal thoughts, but was unrelated to self-harm without intent; findings for paternal suicide attempt were weaker and not significant. Maternal SA, which may not come to the attention of health care professionals, represents a major risk for psychiatric morbidity in their offspring.
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48
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Crepeau-Hobson MF, Leech NL. The impact of exposure to peer suicidal self-directed violence on youth suicidal behavior: a critical review of the literature. Suicide Life Threat Behav 2014; 44:58-77. [PMID: 24033603 DOI: 10.1111/sltb.12055] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 07/02/2013] [Indexed: 11/29/2022]
Abstract
There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross-study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed.
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Genetic and familial environmental effects on suicide attempts: a study of Danish adoptees and their biological and adoptive siblings. J Affect Disord 2014; 155:273-7. [PMID: 24300827 DOI: 10.1016/j.jad.2013.11.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 11/18/2013] [Accepted: 11/18/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Genetic factors have been found to influence the risk of suicide. It is less clear if this also applies to attempted suicide. We have investigated genetic and familial environmental factors by studying the occurrence of suicide attempts in biological and adoptive siblings of adoptees who attempted suicide compared to siblings of adoptees with no suicide attempts. METHOD We used a random sample of 1933 adoptees from the Danish Adoption Register, a register of non-familial adoptions of Danish children, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses were conducted on incidence rates of attempted suicide in biological and adoptive siblings given occurrence of attempted suicide in the adoptees while also taking into account psychiatric disorders. Information about suicidal attempt and history of psychiatric disorder was based on hospital admissions. RESULTS The rate of attempted suicide in full siblings of adoptees who attempted suicide before age 60 years was higher than in full siblings of adoptees who had not attempted suicide (incidence rate ratios (IRR)=3.45; 95% confidence interval [CI]=0.94-12.7). After adjustment for history of psychiatric admission of siblings the increased rate was statistically significant (IRR=3.88; 95% CI-1.42-10.6). LIMITATIONS Information on attempted suicide and psychiatric history was limited to that which involved hospitalisation. CONCLUSIONS Genetic factors influence risk of suicide attempts.
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Pineda Roa CA. [Factors Associated with Suicide in Adolescents and Young People Self-Identified as Lesbian, Gay, and Bisexual: Current State of the Literature]. ACTA ACUST UNITED AC 2013; 42:333-49. [PMID: 26573118 DOI: 10.1016/s0034-7450(13)70030-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 07/23/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION A framework within sexual and reproductive health is presented to understand the mental health issues of the population of lesbian, gay and bisexual (LGB) adolescents and young people. Different ways of understanding the nature of internalized homophobia were developed. On the other hand, in suicidology studies it is understood that the risk of suicide consists of the steps of ideation, planning and attempted suicide, and that there is an increased risk of suicide in the LGB population. Numerous factors have been associated with suicide risk in this population, one of the main internalized homophobia and other mental health problems. OBJECTIVES By means of a literature review, to establish the possible relationship between internalized homophobia and ideation and attempted suicide in the LGB population, as well as to identify the mental health problems associated to suicide risk in sexually diverse communities. METHOD Articles in English and Spanish, mainly within the last five years, were reviewed. They included articles in peer reviewed journals, and databases, such as Google Scholar, Redalyc, Byreme, Ovid, Science Direct, Taylor and Francis, MEDLINE, Scopus, PsycINFO, and Ebsco. RESULTS It was found in the available literature that internalized homophobia is associated with suicide ideation and attempts in adults. A state of science of the major mental health problems associated with suicide risk in young LGB people reported contradictory findings. While some studies showed an association between depression, anxiety and distress and suicidal ideation and attempts, in others, the data do not allow such a conclusion. The theoretical framework presents the most important conceptualizations of suicide risk and emphasizes the social type. It identifies issues of suicide prevention, protective factors that contribute towards this, as well as elements of psychotherapy for LGB consultants. CONCLUSIONS It concludes and discusses the importance of studying the sexually diverse as regards determining factors of mental health in Latin America, given the limited amount of literature found in the Spanish language, and myths of major disease that persist in many segments of the population. This review considers it necessary to overcome such contradictions, in order to inform the general population and avoid further stigmatization.
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