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Yang Y. Lifetime use of multiple substances and youth suicide risk: assessing the role of depressive symptoms using structural equation modeling. Public Health 2024; 234:71-76. [PMID: 38964128 DOI: 10.1016/j.puhe.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVES This study assessed the direct and indirect effects (via depressive symptoms) of lifetime use of a broad range of substances on suicide risk among US adolescents. STUDY DESIGN This was a cross-sectional study. METHODS Data from the 2021 Youth Risk Behavior Survey were used (N = 12,303, 48.7% female). Associations between five types of substance use (cigarette, e-cigarette, alcohol, marijuana, and prescription pain medicine) and three dimensions of suicide risk (suicidal ideation, suicide plan, and suicide attempt) were measured by multivariate logistic regression models. The role of depressive symptoms was further examined by structural equation modeling. RESULTS Almost three in five (57.5%) adolescents had used one or more substances in their lifetime (18.1% one type, 12.2% two types, 13.1% three types, 10.2% four types, and 3.8% five types). Adolescents using five substances were up to 16 times more likely to experience suicidal ideation and behaviors. Depressive symptoms significantly linked the pathway from substance use to suicide risk, resulting in much stronger indirect effects than the direct effects. Collectively, the five substance use behaviors and depressive symptoms explained about 60.4% of variance in suicidal ideation, 53.6% of variance in suicide plan, and 55.0% of variance in suicide attempt. CONCLUSIONS Lifetime use of multiple substances is significantly correlated with suicidal ideation and behaviors among adolescents via the pathway of depressive symptoms. Routine screening for a broad range of substance use behaviors is needed to identify adolescents at risk for suicide and accessible mental health services could potentially attenuate the linkage between substance use and suicide risk.
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Affiliation(s)
- Yingwei Yang
- Social Science Research Institute, Duke University, Durham, NC, USA.
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Olds KL, Tse R, Stables S, Baker AM, Hird K, Langlois NE, Byard RW. An analysis of risk factors for child suicide in three centres from 2008 to 2017. MEDICINE, SCIENCE, AND THE LAW 2024:258024241274914. [PMID: 39175390 DOI: 10.1177/00258024241274914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.
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Affiliation(s)
- Kelly L Olds
- Clinpath Pathology, Mile End, Adelaide, Australia
| | - Rexson Tse
- LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Simon Stables
- LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | | | - Kathryn Hird
- School of Medicine, The University of Notre Dame, Fremantle, Australia
| | - Neil E Langlois
- School of Biomedicine, The University of Adelaide, Adelaide, Australia
- Forensic Science South Australia, Adelaide, Australia
| | - Roger W Byard
- School of Biomedicine, The University of Adelaide, Adelaide, Australia
- Forensic Science South Australia, Adelaide, Australia
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Yang Y. Suicidal Thoughts and Behaviors Among US Adolescents: The Cumulative Effects of Polysubstance Use Behaviors. Subst Use Misuse 2024:1-8. [PMID: 39155480 DOI: 10.1080/10826084.2024.2392504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Background: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide.
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Affiliation(s)
- Yingwei Yang
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
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Katz CC, Okpych N, Wall E, Shelton J, Courtney M. Characteristics of Transition-Age Youth Engaging in Suicidal Behavior. J Adolesc Health 2024:S1054-139X(24)00286-6. [PMID: 39127928 DOI: 10.1016/j.jadohealth.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE Suicide rates are markedly high among children with foster care involvement. Transition-age youth (TAY) who age-out of the foster care system are at particularly high risk. METHODS Analyzing data from the California Youth Transitions to Adulthood Study (n=727), this paper explores the descriptive characteristics of TAY who engage in suicidal behavior with the goals of better identifying, understanding, and supporting those at risk. We report rates of suicidal ideation and suicide attempt at four interview waves (ages 17, 19, 21, 23) and examine differences in rates by sociodemographic characteristics, past maltreatment, and behavioral health disorders. RESULTS At age 17, 42% of California Youth Transitions to Adulthood Study participants had thought of committing suicide and 24% had attempted suicide. Across ages, sexual minority youth reported significantly higher rates of suicidal ideation and behavior than their heterosexual peers. We also found that youth with (1) maltreatment experiences (both before and during foster care); (2) major depressive disorder, anxiety disorder or post-traumatic stress disorder; and (3) alcohol/substance abuse disorders were significantly more likely than their peers without these characteristics/diagnoses to engage in suicidal behavior at certain ages. Youth with comorbid psychiatric and substance use disorders were consistently at elevated risk. DISCUSSION Routine screening for suicidal behavior among TAY is important for child welfare service providers to consider. Youth at risk may benefit from more consistent assessment, mental health care, and targeted mental health intervention. Future research is needed to shed light on mechanisms linking certain sociodemographic, experiential, and behavioral health characteristics with suicidal behavior in TAY.
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Affiliation(s)
- Colleen C Katz
- Hunter College, City University of New York, New York, New York.
| | - Nathanael Okpych
- School of Social Work, The University of Connecticut, Hartford, Connecticut
| | - Eden Wall
- Hunter College, City University of New York, New York, New York
| | - Jama Shelton
- Hunter College, City University of New York, New York, New York
| | - Mark Courtney
- School of Social Welfare, University of California, Berkeley, California
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Rosic T, Lovell E, MacMillan H, Samaan Z, Morgan RL. Components of Outpatient Child and Youth Concurrent Disorders Programs: A Critical Interpretive Synthesis: Composantes des programmes de troubles concomitants des enfants et des jeunes ambulatoires : une synthèse interprétative critique. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:381-394. [PMID: 37941334 PMCID: PMC11107442 DOI: 10.1177/07067437231212037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Co-occurring mental health and substance use disorders (concurrent disorders) lead to significant morbidity in children and youth. Programs for integrated treatment of concurrent disorders have been developed; however, there exists little guidance outlining their structure and activities. Our objective was to synthesize available information on outpatient child and youth concurrent disorders programs and produce a comprehensive framework detailing the components of such programs. METHODS We used a four-stage critical interpretive synthesis design: (1) systematic review of published and grey literature, (2) data abstraction to identify program components and purposive sampling to fill identified gaps, (3) organization of components into a structured framework, (4) feedback from programs. We employed an iterative process by which programs reviewed data abstraction and framework development and provided feedback. RESULTS Through systematic review (yielding 1,408 records total and 7 records eligible for inclusion) and outreach strategies (yielding an additional 7 eligible records), we identified 11 programs (4 American, 7 Canadian) and 2 theoretical models from which data could be abstracted. Program activities were categorized into 12 overarching constructs that make up the components of the framework: accessibility, engagement, family involvement, integrated assessment, psychotherapy for patients, psychotherapy for families, medication management, health promotion, case management, vocational support, recreation and social support, and transition services. Program components are informed by the philosophical orientation of the program and models of care. This framework considers health system factors, clinical service factors, program development, and community partnership that impact program structure and activities. Multidisciplinary teams provide care and include addiction medicine, psychiatry, psychology, nursing, social work, occupational therapy, recreation therapy, peer support, and program evaluation. CONCLUSION We developed a comprehensive framework describing components of child and youth outpatient concurrent disorders programs. This framework may assist programs currently operating, and those in development, to reflect on their structure and activities.
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Affiliation(s)
- Tea Rosic
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Elizabeth Lovell
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Harriet MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Population and Quantitative Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Jean FAM, Moulin F, Schwartz AN, Castel L, Montagni I, Macalli M, Notredame CE, Côté SM, Galéra C. Association between ADHD symptoms and illicit stimulants use following 1 year among French university students of the i-Share cohort. Soc Psychiatry Psychiatr Epidemiol 2024; 59:887-897. [PMID: 37268785 DOI: 10.1007/s00127-023-02499-9] [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: 12/10/2022] [Accepted: 05/24/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE Although attention deficit hyperactivity disorder (ADHD) has been associated with illicit stimulants use, less is known about their prospective association in university students. We aimed to examine the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year among university students. METHODS The i-Share cohort recruited French students from February 2013 to July 2020. The study included 4270 participants. The Adult ADHD Self-Report Scale (ASRS) was used to evaluate ADHD symptoms at inclusion. Illicit stimulants use was assessed at inclusion and 1 year after inclusion. Multivariable logistic regressions were conducted to assess the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year. RESULTS High levels of ADHD symptoms at inclusion were associated with a greater probability of illicit stimulants use following 1 year (adjusted OR: 2.42 (1.51-3.8)). The adjusted odds ratio was 2.7 (1.08-7.84) among participants who had used illicit stimulant at least once (continuation) and 2.25 (1.04-4.37) among participants who had never used illicit stimulants at inclusion (initiation). CONCLUSION High levels of ADHD symptoms are a feature that may promote both initiation and continuation of illicit stimulants use among university students. Our findings suggest that university students with high levels of ADHD symptoms may benefit from screening to help identify those at risk of illicit stimulants use.
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Affiliation(s)
- François A M Jean
- Department of Psychiatry, Dr Jean Eric Techer Hospital, Calais, France
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Flore Moulin
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Ashlyn N Schwartz
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
- Department of Public Health, University of Tennessee, Knoxville, USA
| | - Laura Castel
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Ilaria Montagni
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Mélissa Macalli
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Charles-Edouard Notredame
- University of Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale-INSERM), Lille, France
- Teaching Hospital of Lille (Centre Hospitalier Universitaire de Lille-CHU de Lille), Lille, France
| | - Sylvana M Côté
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
- University of Montreal, Montreal, Canada
| | - Cédric Galéra
- University of Bordeaux, Bordeaux, France.
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France.
- Charles Perrens Hospital, Bordeaux, France.
- Pôle Universitaire de Psychiatrie de L'enfant et de L'adolescent, Centre Hospitalier Charles-Perrens, 146Bis, rue Léo-Saignat, 33076, Bordeaux, France.
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Baiden P, LaBrenz CA, Broni MN, Baiden JF, Adepoju OE. Prevalence of youth experiencing homelessness and its association with suicidal thoughts and behaviors: Findings from a population-based study. Psychiatry Res 2024; 334:115823. [PMID: 38430817 DOI: 10.1016/j.psychres.2024.115823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Although various studies have examined factors associated with suicidal behaviors among youth, few studies have investigated the association between youth experiencing homelessness (YEH) and suicidal thoughts and behaviors (STBs) using a large nationally representative sample. The objectives of this study were to investigate prevalence of YEH and its association with STBs. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 youth aged 14-18 (51.7 % male) was analyzed using binary logistic regression. Of the 17,033 youth examined, 3 % experienced homelessness during the past 30 days, 21.3 % experienced suicidal ideation, 17.3 % made a suicide plan, and 10.9 % attempted suicide during the past 12 months. Controlling for demographic characteristics and feeling sad or hopeless, YEH was associated with 2.48 times higher odds of experiencing suicidal ideation (AOR=2.48, p<.001), 2.46 times higher odds of making a suicide plan (AOR=2.46, p<.001), and 4.38 times higher odds of making a suicide attempt (AOR=4.38, p<.001). The findings of this study highlight the importance of identifying youth who are at risk of experiencing homelessness to ensure early interventions are put in place to prevent suicidal behaviors.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019, United States.
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019, United States
| | - Marisa N Broni
- University of Ghana, School of Public Health, P. O. Box LG 25, Legon, Accra, Ghana
| | - John F Baiden
- East Airport International School, P. O. Box KAPM 57, KIA, Accra, Ghana
| | - Omolola E Adepoju
- University of Houston, Tilman J. Fertitta Family College of Medicine, 5055 Medical Circle, Houston, TX 77204, United States
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Welsh JW, Dopp AR, Durham RM, Sitar SI, Passetti LL, Hunter SB, Godley MD, Winters KC. Narrative review: Revised Principles and Practice Recommendations for Adolescent Substance Use Treatment and Policy. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00140-0. [PMID: 38537736 DOI: 10.1016/j.jaac.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE In 2014, the U.S. National Institute on Drug Abuse released the "Principles of Adolescent Substance Use Disorder Treatment," summarizing previously established evidence and outlining principles of effective assessment, treatment, and aftercare for substance use disorders (SUD). Winters et al. (2018) updated these principles to be developmentally appropriate for adolescents. This review builds on that formative work and recommends updated adolescent assessment, treatment, and aftercare principles and practices. METHOD The Cochrane, MEDLINE-PubMed, and PsychInfo databases were searched for relevant studies with new data about adolescent substance use services. This article updates the 13 original principles; condenses the 8 original modalities into 5 practices; and highlights implications for public policy approaches, future funding, and research. RESULTS Key recommendations from the principles include integrating care for co-occurring mental health disorders and SUDs, improving service accessibility including through the educational system, maintaining engagement, and addressing tension between agencies when collaborating with other youth service systems. Updates to the treatment practices include adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT), investment in social programs and family involvement in treatment, expanding access to behavioral therapies and medications, increasing funding to harm reduction services, supporting reimbursement for continuing care services, and increasing investment in research. CONCLUSION These revised principles of adolescent assessment, treatment, and aftercare approaches and practices aim to establish guidance and evidence-based practices for treatment providers, while encouraging necessary support from policymakers and funding agencies to improve the standard of care for adolescent SUD services.
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Baral A, Hanna F, Chimoriya R, Rana K. Cannabis Use and Its Impact on Mental Health in Youth in Australia and the United States: A Scoping Review. EPIDEMIOLOGIA 2024; 5:106-121. [PMID: 38534804 DOI: 10.3390/epidemiologia5010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Cannabis is a widely used substance among the youth population, with an estimated 2.8% currently smoking cannabis. Its popularity is growing due to the perception of its harmless nature and lack of dependence. However, this increase in use has been linked to mental health issues, especially since its partial decriminalisation in some part of the United States and Australia. The objective of this scoping review was to investigate the mental health impact of cannabis use among young people in Australia and the United States. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from ProQuest Central and EBSCO Host (MEDLINE and CINAHL databases). A total of 24 articles were analysed, including systematic reviews, meta-analyses, and cohort, longitudinal, and cross-sectional studies. The findings indicate that cannabis use is associated with depression, psychosis, suicide, cannabis use disorder, dependence, decline in cognitive function, and the development of externalising behaviour, particularly attention deficit hyperactivity disorder. However, the relationship between cannabis use and anxiety is equivocal. Mental health issues were more prevalent with increased frequency, duration, intensity, and type of use. Female, minority, LGBTQI, African American, Aboriginal, and Torres Strait Islander youth and the age of onset of cannabis use were significant factors for the development of mental health problems. The increasing prevalence of cannabis use among high school and college students suggests the need for intervention by teachers, parents, and community health professionals to make them aware of its potential negative mental health outcomes. Moreover, policy-level interventions by the government are required to discourage young people from using cannabis.
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Affiliation(s)
- Aayush Baral
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
| | - Fahad Hanna
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
| | - Ritesh Chimoriya
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Kritika Rana
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
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Peprah P, Oduro MS, Okwei R, Adu C, Asiamah-Asare BY, Agyemang-Duah W. Cyberbullying victimization and suicidal ideation among in-school adolescents in three countries: implications for prevention and intervention. BMC Psychiatry 2023; 23:944. [PMID: 38098109 PMCID: PMC10720188 DOI: 10.1186/s12888-023-05268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/09/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Countries in South and Central America and the Caribbean are among the countries with the highest adolescent cyberbullying crimes. However, empirical evidence about the effect of cyberbullying victimization on suicidal ideation among in-school adolescents in these countries remains limited. The present study examined the association between cyberbullying victimization and suicidal ideation among in-school adolescents in Argentina, Panama, St Vincent, and the Grenadines. METHODS A representative cross-sectional data from 51,405 in-school adolescents was used. Hierarchical logistic regression analysis was used to estimate the association between cyberbulling victimization and suicidal ideation. RESULTS Overall, 20% and 21.1% of the adolescents reported cyberbullying victimization and suicidal ideation, respectively in the past year before the survey. Suicidal ideation was higher among adolescents who experienced cyberbullying victimization (38.4%) than those who did not experience cyberbullying victimization (16.6%). Significantly higher odds of suicidal ideation were found among adolescents who had experienced cyberbullying victimization than those who had not experienced cyberbullying victimization [aOR = 1.88, 95% CI: 1.77-1.98]. CONCLUSION This finding calls for developing and implementing evidence-based programs and practices by school authorities and other relevant stakeholders to reduce cyberbullying victimization among adolescents in this digital age. Protective factors such as parental support and peer support should be encouraged.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
- Centre for Primary Health Care and Equity, University New South Wales, Sydney, Australia
| | - Michael Safo Oduro
- Department of Applied Statistics and Research Methods, University of Northern Colorado, Greeley, CO, USA
- Pfizer Worldwide Research and Development, Pharm Sci and PGS Statistics, Groton, CT, USA
| | - Reforce Okwei
- Department of Geography and Environment, Western University, 1151 Richmond Street, N6A 3K7, London, Ontario, Canada
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
| | - Bernard Yeboah Asiamah-Asare
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Benny C, Siddiqi A, Pabayo R. Income inequality and 'hospitalisations of despair' in Canada: a study on longitudinal, population-based data. J Epidemiol Community Health 2023; 78:33-39. [PMID: 37739771 DOI: 10.1136/jech-2023-220900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Rates of drug overdoses, alcohol-related liver disease and suicide attempts represent a major public health burden in Canada. While the existing literature does highlight some evidence of association between income inequality and mental health and deaths of despair, no existing research has investigated more intermediate events. As such, the objective of the current study is to investigate the association between income inequality and hospitalisations of despair over time. METHODS Data from the 2006 Canadian Census, the 2007/2008 Canadian Community Health Survey and the 2007-2018 Discharge Abstract Database were linked. Data were analysed using Cox proportional hazards modelling accounting for robust standard errors at the area level to investigate associations between income inequality at baseline and hazards for hospitalisations of despair, hospitalisations attributable to drug overdose, alcohol-related liver disease and suicide attempts, and all-cause hospitalisations, while controlling for sociodemographics characteristics (including income) and relevant area-level variables. RESULTS The results highlighted statistically significant associations between income inequality and hazard of hospitalisations of despair (HR 1.38, 95% CI 1.06 to 1.80), hospitalisations related to drug overdose (HR 1.51, 95% CI 1.07 to 2.13) and all-cause hospitalisations (HR 1.17, 95% CI 1.05 to 1.30). The association between income inequality and hospitalisations related to alcohol-related liver disease and suicide attempts/self-harm were not statistically significant. CONCLUSION Overall, the results showed evidence of associations between income inequality and hospitalisations of despair, drug overdose-related hospitalisations and all-cause hospitalisations. These findings are applicable to upstream policy discussion regarding reducing income inequality and identify potential points of intervention for prevention of drug overdose, alcohol-related liver disease and suicide attempts/self-harm.
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Affiliation(s)
- Claire Benny
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Oladunjoye AF, Li E, Aneni K, Onigu-Otite E. Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States. PLoS One 2023; 18:e0292922. [PMID: 37847698 PMCID: PMC10581466 DOI: 10.1371/journal.pone.0292922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. OBJECTIVES To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. METHODS We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10-19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. RESULTS 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3-1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). CONCLUSIONS Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.
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Affiliation(s)
- Adeolu Funso Oladunjoye
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, United States of America
| | - Elijah Li
- School of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Kammarauche Aneni
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Edore Onigu-Otite
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, United States of America
- School of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
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Wang Q, Wang H. Cannabis and tobacco use among adolescents aged 12-17 years from 16 low- and middle-income countries. J Glob Health 2023; 13:04066. [PMID: 37499128 PMCID: PMC10374269 DOI: 10.7189/jogh.13.04066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
Background We aimed to examine the association between cannabis use and tobacco use in 12-17-year-old adolescents residing in low- and middle-income countries (LMICs). Methods We used data from the Global School-based Student Health Survey collected between 2012 and 2022. We selected 16 LMICs based on pre-defined inclusion criteria and compared the prevalence of cannabis use for female and for male adolescents for each country. We estimated age- and sex-standardised distributions of tobacco use, school truancy, suicide attempt, sex with multiple partners, physical fighting, perceived school kindness, and parental monitoring were estimated. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) measuring associations between cannabis use and other variables. We generated pooled estimates through random effects meta-analyses. Results The overall pooled prevalence of cannabis use was 4.3% (95% CI = 3.2-5.9), with significant between-country heterogeneities (I2 = 91.4%; P = 0.000). Cannabis use was more prevalent in males than in females in each country. Tobacco use was strongly associated with cannabis use in all 16 LMICs. Tobacco users had approximately 11 to 14 times greater odds of cannabis use than non-tobacco users. Sex with multiple partners, suicide attempts, and school truancy had a robust association with cannabis use in over half of LMICs. Conclusions There is a need for comprehensive preventive measures targeting multiple risk behaviours associated with cannabis use for adolescents in LMICs.
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Affiliation(s)
- Qian Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Systems Medicine for Cancer, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Posamentier J, Seibel K, DyTang N. Preventing Youth Suicide: A Review of School-Based Practices and How Social-Emotional Learning Fits Into Comprehensive Efforts. TRAUMA, VIOLENCE & ABUSE 2023; 24:746-759. [PMID: 35139714 DOI: 10.1177/15248380211039475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Schools in the United States increasingly incorporate social-emotional learning (SEL) as a part of comprehensive youth suicide prevention programs in schools. We reviewed the literature to investigate the inclusion of SEL in youth suicide prevention efforts. We identified several known risk factors to youth suicide, namely, hopelessness, anxiety, substance use, and child sexual abuse, then cross-walked that review to SEL competencies shown to mitigate each of those known risk factors. We found all SEL competencies, to some extent, across all the evidence-based, school-based youth suicide prevention programs we identified. Further, we found that all five SEL competencies are shown directly to address and mitigate the major, known risk factors for youth suicide. These findings suggest that SEL can play a productive role in upstream youth suicide prevention. State-level policy makers and school administrators should consider the inclusion of evidence-based SEL in efforts to address youth suicide prevention.
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[What is the contribution of smoking to the increased risk of suicide in young smokers? A systematic review]. L'ENCEPHALE 2023; 49:72-86. [PMID: 36253173 DOI: 10.1016/j.encep.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The correlation between smoking and suicide is well documented in the general population: there is an increased risk of suicide among tobacco smokers. However, the association between smoking and suicidal behaviors (ideations, plans, attempts) in youth is poorly elucidated. This is a systematic review of the literature examined data on the relationship between active and passive smoking and suicidal ideation (SI), suicide planning (SP), and suicide attempts (SA) among youth in the general population. METHOD Medline searches were performed for the period 1980-2020. Cross-sectional, case-control, prospective population-based studies of young people (age less than 18 years) were included in this review; studies of specific populations (patients with an identified pathology of any kind) were excluded. RESULTS This review included 43 studies: 23 studies on the association between active smoking and SI, SI and/or PS, TS; three studies on the association between passive smoking and suicidal behavior, three studies on the association between smoking and suicidal behavior in young people in psychiatric hospital settings, and five studies comparing the suicidal behavior of girls and boys. Analysis of the data collected lead to the conclusion that active or passive smoking is associated with suicidal behavior in young people. Smoking appears to contribute to psychopathological disorders, including depression, the use of other psychoactive substances, or psychosocial suffering which are often associated with an increased risk of suicide in young people. The correlations between smoking and the presence of mental disorders have been highlighted; tobacco use may contribute to the development of depression, anxiety and stress. Further studies are needed to verify the existence of a causal link between smoking and suicide. CONCLUSION Smoking is associated with the risk of suicidal behavior in young people; it should be included among the criteria for assessing suicidal risk in youth. Smoking cessation, which improves psychological well-being, should be further integrated into the prevention of suicidal behavior.
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Ortiz SN, Grunewald W, Morgan R, Smith A. Examining the relationship between dysmorphia symptoms and suicidality through the lens of the Interpersonal Theory of Suicide. J Clin Psychol 2023; 79:541-557. [PMID: 35988134 PMCID: PMC10087364 DOI: 10.1002/jclp.23433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/04/2022] [Accepted: 08/07/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Using the Interpersonal Theory of Suicide (IPTS) as a framework, this two-study investigation tested whether burdensomeness and low belongingness explained the association between body and muscle dysmorphia symptoms and suicidal ideation (tested in Study 1 and Study 2), and if fearlessness about death and pain tolerance explained the association between dysmorphia symptoms and previous suicide attempt frequency (tested in Study 2). METHODS Study 1 used a community sample (n = 273) and Study 2 used an at-risk population sample (n = 261). Participants completed cross-sectional questionnaires online. RESULTS In Study 1, both types of dysmorphic symptoms related to suicidal ideation through burdensomeness, but only body dysmorphic symptoms related to suicidal ideation through low belongingness. In Study 2, results were replicated as both types of dysmorphic symptoms related to suicidal ideation through burdensomeness. While both types of symptoms related to low belonging, low belonging did not relate to suicidal ideation. Neither dysmorphic symptoms nor capability for suicide related to frequency of suicide attempts. CONCLUSIONS Results suggest that improving interpersonal needs, such as feeling more effective, may be important treatment targets for individuals with dysmorphic symptoms who also experience suicidal ideation. Future work should continue to identify mediators for suicide attempts among individuals with dysmorphia symptoms.
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Affiliation(s)
- Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | | | - Robert Morgan
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - April Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
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Onaemo VN, Fawehinmi TO, D’Arcy C. Risk of suicide ideation in comorbid substance use disorder and major depression. PLoS One 2022; 17:e0265287. [PMID: 36477246 PMCID: PMC9728854 DOI: 10.1371/journal.pone.0265287] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Suicidal behaviour is commonly associated with major depression (MD) and substance use disorders (SUDs). However, there is a paucity of research on risk for suicide ideation among individuals with comorbid SUDs and MD in the general population. OBJECTIVES This study investigated the associated risk of suicide ideation in comorbid SUDs-cannabis use disorder (CUD), alcohol use disorder (AUD), drug use disorder (DUD) with major depressive episode (MDE) in a nationally representative sample. METHODS Multilevel logistic regression models were used to analyze the 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data. This is a cross-sectional survey of nationally representative samples of Canadians (n = 25,113) aged 15 years and older residing in the ten Canadian provinces between January and December 2012. Diagnoses of MDE, AUD, DUD, and CUD were based on a modified WHO-CIDI, derived from DSM-IV diagnostic criteria. RESULTS Comorbidity was found to be the strongest predictor of suicide ideation. Compared to those with no diagnosis of either a SUD or MDE, individuals with a comorbid diagnosis of AUD with MDE, CUD with MDE, or DUD with MDE were 9, 11 and 16 times more likely to have 12-month suicide ideation respectively. A diagnosis of MDE was a significant predictor of 12-month suicide ideation with about a 7-fold increased risk compared with individuals not diagnosed with either MDE or a SUD. CONCLUSION Suicide is a preventable public health issue. Our study found a significantly increased risk of suicide ideation among persons who have comorbid SUD with MD. Effective integration of mental health and addictions services could mitigate the risk of suicide and contribute to better outcomes.
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Affiliation(s)
- Vivian N. Onaemo
- Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- * E-mail:
| | | | - Carl D’Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Turuba R, Amarasekera A, Howard AM, Brockmann V, Tallon C, Irving S, Mathias S, Henderson J, Marchand K, Barbic S. A qualitative study exploring how young people perceive and experience substance use services in British Columbia, Canada. Subst Abuse Treat Prev Policy 2022; 17:43. [PMID: 35643591 PMCID: PMC9148204 DOI: 10.1186/s13011-022-00456-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Substance use among youth (ages 12–24) is troublesome given the increasing risk of harms associated. Even more so, substance use services are largely underutilized among youth, most only accessing support when in crisis. Few studies have explored young people’s help-seeking behaviours to address substance use concerns. To address this gap, this study explored how youth perceive and experience substance use services in British Columbia (BC), Canada. Methods Participatory action research methods were used by partnering with BC youth (under the age of 30) from across the province who have lived and/or living experience of substance use to co-design the research protocol and materials. An initial focus group and interviews were held with 30 youth (ages 12–24) with lived and/or living experience of substance use, including alcohol, cannabis, and illicit substances. The discussions were audio-recorded, transcribed verbatim, and analyzed thematically using a data-driven approach. Results Three main themes were identified and separated by phase of service interaction, starting with: Prevention/Early intervention, where youth described feeling unworthy of support; Service accessibility, where youth encountered many barriers finding relevant substance use services and information; and Service delivery, where youth highlighted the importance of meeting them where they are at, including supporting those who have milder treatment needs and/or do not meet the diagnosis criteria of a substance use disorder. Conclusions Our results suggest a clear need to prioritize substance use prevention and early interventions specifically targeting youth and young adults. Youth and peers with lived and/or living experience should be involved in co-designing and co-delivering such programs to ensure their relevance and credibility among youth. The current disease model of care leaves many of the needs of this population unmet, calling for a more integrated youth-centred approach to address the multifarious concerns linked to young people’s substance use and service outcomes and experiences.
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Cannabis and Intentional Self-injury: a Narrative Review. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Purpose of Review
Observational studies assessing the association of cannabis use with subsequent intentional self-injury have reported mixed findings. Longitudinal studies examining the association of cannabis use with subsequent suicide death are notably rare. Our objective was to review longitudinal studies examining cannabis use and subsequent self-harm, suicide attempt, or suicide death.
Recent Findings
Few population-based studies have focused on self-harm with considerable variability across studies in how this outcome has been operationalized. Studies assessing the association between cannabis use and suicide attempt are equivocal in their conclusions and heterogenous in terms of samples utilized and assessment of confounding bias. The results of one meta-analysis were suggestive of dose dependency. For suicide death, the findings are inconsistent, and there is reason for concern of selection bias.
Summary
The existing evidence base on these associations is not yet rigorous enough to allow drawing conclusions on causality. However, cannabis might be seen as an adverse prognostic marker for intentional self-injury.
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Armoon B, Fleury MJ, Bayani A, Mohammadi R, Ahounbar E, Griffiths MD. Suicidal behaviors among intravenous drug users: a meta-analysis. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2120435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bahram Armoon
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Marie-Josée Fleury
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, the National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Kassie GM, Lemu YM, Biresaw MS, Dessie GM, Tadesse GT, Gared WM, Belay MW. Suicidal ideation and attempt and associated factors among patients with substance use disorder: institution-based cross-sectional study. BJPsych Open 2022; 8:e150. [PMID: 35912979 PMCID: PMC9380183 DOI: 10.1192/bjo.2022.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND No published research in Ethiopia has examined the prevalence of suicidal ideation and suicide attempts and associated factors among patients with substance use disorder. AIMS The main aim of this study was to assess the prevalence of suicidal ideation, suicide attempt and associated factors among patients with substance use disorders. METHOD An institution-based cross-sectional study was conducted from 5 May to 13 June 2019 in Addis Ababa. A total of 408 patients were identified using a systematic sampling technique. Data were collected through interviews using the suicidality module of the Composite International Diagnostic Interview. Data were entered into EpiData and analysed using SPSS. Logistic regression analyses were employed. Variables with P < 0.05 were considered to be statistically significant with 95% confidence intervals. RESULTS Prevalence rates of suicidal ideation and attempt were found to be 39.5% and 18.6%, respectively. Family history of mental illness (adjusted odds ratio (AOR) = 3.60, 95% CI: 2.17, 5.97), comorbid mental illness (AOR = 3.61, 95% CI: 2.11, 6.16), perceived stigma related to substance misuse (AOR = 4.00, 95% CI: 2.26, 7.07) and alcohol use (AOR = 7.49, 95% CI: 1.99, 28.19) were associated with suicidal ideation. Being female (AOR = 2.46, 95% CI: 1.08, 5.70), family history of suicide (AOR = 3.08, 95% CI: 1.68, 5.64), comorbid mental illness (AOR = 4.09, 95% CI: 2.23, 7.49) and khat use (AOR = 3.73, 95% CI: 1.24, 11.17) were associated with suicide attempt. CONCLUSIONS The prevalence of suicidal ideation and attempt were both found to be high. In particular, patients who had a comorbid mental illness were at high risk of both suicidal ideation and attempt. Therefore, special attention should be given to those with a family history of suicide or comorbid mental illness.
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Affiliation(s)
- Gebeyaw Molla Kassie
- Department of Psychiatry, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Yohanes Mirekena Lemu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu Biresaw
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | | | - Woredaw Minichil Gared
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mesele Wonde Belay
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Moller CI, Davey CG, Badcock PB, Wrobel AL, Cao A, Murrihy S, Sharmin S, Cotton SM. Correlates of suicidality in young people with depressive disorders: A systematic review. Aust N Z J Psychiatry 2022; 56:910-948. [PMID: 35362327 DOI: 10.1177/00048674221086498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. METHOD Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15-25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. RESULTS We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. CONCLUSION Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.
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Affiliation(s)
- Carl I Moller
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Anna L Wrobel
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Alice Cao
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean Murrihy
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Sonia Sharmin
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Bundoora, VIC, Australia
- Research and Evaluation, Take Two, Berry Street, Eaglemont, VIC, Australia
- Department of Public Health, Torrens University Australia, Melbourne, VIC, Australia
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
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Do Cigarette Smoking and Amphetamine Use Predict Suicide Behaviors Among Adolescents in Liberia? Findings from a National Cross-sectional Survey. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00867-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Iverson GL, Karr JE. Association Between Concussions and Suicidality in High School Students in the United States. Front Neurol 2022; 13:810361. [PMID: 35493820 PMCID: PMC9039310 DOI: 10.3389/fneur.2022.810361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Importance Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality. Objective To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables. Design This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender. Setting A national sampling of U.S. high school students. Participants Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls. Exposure(s) Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality. Main Outcomes and Measures The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis. Results The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)]. Conclusions and Relevance There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Spaulding Research Institute, Charlestown, MA, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, MA, United States
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States
- *Correspondence: Grant L. Iverson
| | - Justin E. Karr
- Department of Psychology, University of Kentucky, Lexington, KY, United States
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Agyemang DO, Madden EF, English K, Venner KL, Handy R, Singh TP, Qeadan F. The mediation and moderation effect of social support on the relationship between opioid misuse and suicide attempts among native American youth in New Mexico: 2009-2019 Youth Risk Resiliency Survey (NM-YRRS). BMC Psychiatry 2022; 22:243. [PMID: 35382787 PMCID: PMC8985366 DOI: 10.1186/s12888-022-03900-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/30/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Suicide attempt and opioid misuse continue to be major behavioral health challenges among American Indians and Alaska Natives (AI/AN). The aim of the study is to evaluate the mediating and moderating role that social support (SS) plays in their association among AI/AN high-school students in New Mexico (NM). METHODS An aggregated NM Youth Resiliency and Risk Survey (NM-YRRS, 2009-2019: odd years) dataset was used. Multivariable logistic regression modeling and mediation analysis were conducted while adjusting for confounding variables. RESULTS Overall, 12.0 and 14.0% of AI/AN students reported opioid misuse and suicide attempt, respectively. The adjusted odds ratio of suicide attempt in students with high SS relative to low SS who misused opioids was 0.43 (p-value = 0.007). The effect of high SS relative to low SS among males who misused opioids was more pronounced (AOR = 0.24, p-value < 0.0001) compared to females (AOR = 0.43, p-value = 0.007). Relative to low SS, high SS was protective for suicide attempt among AI/AN students who misused opioids and attended school in off-reservation (AOR = 0.42, p-value = 0.012) communities, rural communities (AOR = 0.44, p = 0.040), and in communities that are both rural and off-reservation (AOR = 0.39, p = 0.035). Overall, 23.64, and 41.05% of the association between opioid misuse, and suicide attempt was mediated and moderated by SS, respectively. The mediation effect of SS was lowest for rural, on-reservation schools. CONCLUSION More resources need to be allocated to rural on-reservation schools to enhance social support. The study highlights key insights into the significant role SS plays in promoting health and mitigating the association between opioid misuse and suicide attempt.
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Affiliation(s)
- Daniel Opoku Agyemang
- grid.223827.e0000 0001 2193 0096Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, USA
| | - Erin Fanning Madden
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Santa Fe, NM USA
| | - Kamilla L. Venner
- grid.266832.b0000 0001 2188 8502Department of Psychology, Center on Alcohol, Substance use, And Addiction (CASAA), University of New Mexico, Albuquerque, USA
| | - Rod Handy
- grid.223827.e0000 0001 2193 0096Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, USA
| | - Tejinder Pal Singh
- grid.223827.e0000 0001 2193 0096Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, USA
| | - Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, US, United States.
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Quimby EG, Brogan L, Atte T, Diamond G, Fein JA. Evaluating Adolescent Substance Use and Suicide in the Pediatric Emergency Department. Pediatr Emerg Care 2022; 38:e595-e599. [PMID: 35100762 DOI: 10.1097/pec.0000000000002453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study evaluates the relationship between substance use and impairment and current suicidal thoughts or behaviors in adolescent patients screened in a pediatric emergency department (ED). METHODS Data were collected between June 2013 and February 2018 from adolescent patients who presented to a single, urban, pediatric ED. Adolescents completed a computerized, self-administered assessment that evaluates depression, suicide, posttraumatic stress, violence, traumatic exposure, bullying, and substance use. Assessments are administered as standard care to all ED patients aged 14 to 18 years. We used binary logistic regression to estimate the odds of reporting current suicidal thoughts or behaviors associated with patient demographics (ie, age, sex, and race), substance use in the past month, and substance-related impairment. RESULTS A total of 11,623 adolescent patients (65.4% female and 52.9% African American) completed the assessment. Participants were, on average, 15.7 years old (SD = 1.27). Younger age (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.74-0.84) and substance use impairment (OR, 0.44; 95% CI, 0.33-0.58) decreased the odds of reporting current suicidal thoughts or behaviors, whereas male sex (OR, 1.51; 95% CI, 1.28-1.79) and those with past-month substance use (OR, 1.85; 95% CI, 1.51-2.26) increased the odds. CONCLUSIONS Recent substance use and male sex are associated with a higher likelihood of adolescents reporting current suicidal thoughts or behaviors during an ED visit. Standardized screening during pediatric ED visits may allow for more efficient evaluation of patients in higher-risk groups.
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Affiliation(s)
- Ernika G Quimby
- From the Division of Emergency Medicine, Cooper University Hospital, Camden, NJ
| | | | - Tita Atte
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University
| | - Guy Diamond
- Center for Family Intervention Science, College of Nursing and Health Professions, Drexel University
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Okado I, Floyd FJ, Goebert D, Sugimoto-Matsuda J, Hayashi K. Applying ideation-to-action theories to predict suicidal behavior among adolescents. J Affect Disord 2021; 295:1292-1300. [PMID: 34706443 DOI: 10.1016/j.jad.2021.08.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/31/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although many risk factors for adolescent suicidal behavior have been identified, less is known about distinct risk factors associated with the progression from suicide ideation to attempts. Based on theories grounded in the ideation-to-action framework, we used structural equation modeling to examine risk and protective factors associated with the escalation from suicide ideation to attempts in adolescents. METHODS In this cross-sectional study, data from the 2013 and 2015 Hawaii High School Youth Risk Behavior Surveys (N = 8,113) were analyzed. The sample was 54.0% female and racially/ethnically diverse. Risk factors included depression, victimization, self-harm, violent behavior, disinhibition, and hard substance use, and protective factors included adult support, sports participation, academic achievement and school safety. RESULTS One in 6 adolescents (16.4%) reported suicide ideation, and nearly 1 in 10 (9.8%) adolescents had made a suicide attempt. Overall, disinhibition predicted the escalation to attempts among adolescents with suicide ideation, and higher academic performance was associated with lower suicide attempt risk. Depression and victimization were associated with suicide ideation. LIMITATIONS This study examined data from the Youth Risk Behavior Survey, and other known risk factors such as anxiety and family history of suicide were not available in these data. CONCLUSIONS Findings provide guidance for targets for clinical interventions focused on suicide prevention. Programs that incorporate behavioral disinhibition may have the greatest potential for reducing suicide attempt risk in adolescents with suicidal thoughts.
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Affiliation(s)
- Izumi Okado
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States.
| | - Frank J Floyd
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Deborah Goebert
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Jeanelle Sugimoto-Matsuda
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Kentaro Hayashi
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
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Crossin R. Exploring the link between adolescent inhalant misuse and suicidal behaviour: a behavioural toxicology perspective. Neurotoxicol Teratol 2021; 88:107038. [PMID: 34678460 DOI: 10.1016/j.ntt.2021.107038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
Adolescent inhalant misuse has a known association with suicidal thoughts and behaviour. This association persists even after inhalant misuse has ceased. Previous studies have hypothesised that this association may derive from socioeconomic disadvantage or vulnerability, and potentially mediated by impulsivity. This association may also be due to the central nervous system depressant effects of inhalants. This review takes a behavioural toxicology perspective, focussed particularly on the serotonergic system and the Hypothalamic-Pituitary-Adrenal (HPA) axis, as potential links between adolescent inhalant misuse and suicidal behaviour. The challenges of bridging the pre-clinical and clinical literature in this area are discussed, along with promising avenues for future research; ultimately aimed at reducing suicide risk in a vulnerable adolescent population group.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago (Christchurch), Christchurch 8140, New Zealand.
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Randall J, York JA. Lessons Learned from the Impact of Adolescents’ Internet Use Disorders on Adolescents’ Substance Use Disorders. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1967247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jeff Randall
- Medical University of South Carolina, Charleston, SC, USA
| | - Janet A. York
- Medical University of South Carolina, College of Nursing, Charleston, SC, USA
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30
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Sampasa-Kanyinga H, Bakwa-Kanyinga F, Chaput JP, Hamilton HA, Elton-Marshall T, Colman I. Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents. Soc Psychiatry Psychiatr Epidemiol 2021; 56:783-791. [PMID: 32909052 DOI: 10.1007/s00127-020-01958-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/01/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The present study examined associations between nonmedical use of prescription opioids and serious psychological distress, suicidal ideation, and suicide attempts, and tested whether age and sex moderate these relationships. METHODS Data on 5582 adolescents were obtained from a representative province-wide survey of students in grades 7 through 12 (mean age: 15.3 years) across Ontario, Canada. Nonmedical use of prescribed opioids in the last 12 months was categorized in "no use", "infrequent use (1-2 times)", and "regular use (3 times or more)". Logistic regression analysis was adjusted for age, sex, ethnicity, subjective socioeconomic status, and other substance use (i.e., tobacco cigarette, alcohol, cannabis). RESULTS Overall, regular nonmedical use of prescription opioids was strongly associated with greater odds of serious psychological distress (OR: 3.47; 95% CI 1.42-8.45), suicidal ideation (OR: 2.73; 95% CI 1.84-4.05), and suicide attempts (OR: 3.21; 95% CI 1.40-7.37). However, infrequent nonmedical use of prescription opioids was associated with greater odds of serious psychological distress (OR: 1.79; 95% CI 1.08-2.98) and suicidal ideation (OR: 1.63; 95% CI 1.20-2.21), but not suicide attempts (OR: 1.84; 95% CI 0.76-4.45). Age-stratified analyses showed that both infrequent (OR: 1.61; 95% CI 1.01-2.58) and regular (OR: 3.40; 95% CI 2.11-5.46) nonmedical use of prescription opioids was strongly associated with greater odds of suicidal ideation among 15- to 20-year-olds, but not 11- to 14-year-olds. CONCLUSION These findings suggest that nonmedical use of prescription opioids is strongly associated with mental health problems among adolescents. Future research using a longitudinal design is needed to confirm age differences and temporality.
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Affiliation(s)
- Hugues Sampasa-Kanyinga
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
| | - Felly Bakwa-Kanyinga
- Department of Social and Preventive Medicine, Laval University, Quebec City, QC, Canada
| | - Jean-Philippe Chaput
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.,Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Hayley A Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Zeifman R, Singhal N, Breslow L, Weissman CR. On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review. ACS Pharmacol Transl Sci 2021; 4:436-451. [PMID: 33860173 PMCID: PMC8033757 DOI: 10.1021/acsptsci.1c00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 12/13/2022]
Abstract
Use of classic psychedelics (e.g., psilocybin, ayahuasca, and lysergic acid diethylamide) is increasing, and psychedelic therapy is receiving growing attention as a novel mental health intervention. Suicidality remains a potential safety concern associated with classic psychedelics and is, concurrently, a mental health concern that psychedelic therapy may show promise in targeting. Accordingly, further understanding of the relationship between classic psychedelics and suicidality is needed. Therefore, we conducted a systematic review of the relationship between classic psychedelics (both non-clinical psychedelic use and psychedelic therapy) and suicidality. We identified a total of 64 articles, including 41 articles on the association between non-clinical classic psychedelic use and suicidality and 23 articles on the effects of psychedelic therapy on suicidality. Findings on the association between lifetime classic psychedelic use and suicidality were mixed, with studies finding positive, negative, and no significant association. A small number of reports of suicide and decreased suicidality following non-clinical classic psychedelic use were identified. Several cases of suicide in early psychedelic therapy were identified; however, it was unclear whether this was due to psychedelic therapy itself. In recent psychedelic therapy clinical trials, we found no reports of increased suicidality and preliminary evidence for acute and sustained decreases in suicidality following treatment. We identify some remaining questions and provide suggestions for future research on the association between classic psychedelics and suicidality.
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Affiliation(s)
- Richard
J. Zeifman
- Department
of Psychology, Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Nikhita Singhal
- Department
of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | - Leah Breslow
- Independent
Researcher, Toronto, Ontario, Canada
| | - Cory R. Weissman
- Department
of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
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32
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Christie NC. The role of social isolation in opioid addiction. Soc Cogn Affect Neurosci 2021; 16:645-656. [PMID: 33681992 PMCID: PMC8259283 DOI: 10.1093/scan/nsab029] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 12/23/2022] Open
Abstract
Humans are social animals: social isolation hurts people both psychologically and physically. Strong, positive social bonds help people to live longer and healthier lives compared with their more isolated peers. Opioid use disorder is associated with feelings of social isolation, an increased risk of suicide and, at the community level, lower social capital. I propose a psychobiological mechanistic explanation that contributes to the association between opioid use and social isolation. The endogenous opioid system plays a central role in the formation and maintenance of social bonds across the life span and has been investigated primarily through the framework of the brain opioid theory of social attachment. In primates, maternal-infant bonding and social play are both impaired by the administration of naltrexone (an opioid antagonist), and in humans, the chronic use of opioids appears to be particularly (relative to other drugs) corrosive to close relationships. Social isolation may play a role in the development and exacerbation of opioid use disorder. Taken together, work on the brain’s opioid system suggests a possible mechanistic basis for bidirectional causal links between social isolation and opioid use disorder. Evaluation of this hypothesis would benefit from longitudinal psychosocial and neuropsychopharmacological investigations.
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Affiliation(s)
- Nina C Christie
- Department of Psychology, University of Southern California, Los Angeles, CA, USA., USC Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
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Hogue A, Henderson CE, Ozechowski TJ, Becker SJ, Coatsworth JD. Can the group harm the individual? Reviewing potential iatrogenic effects of group treatment for adolescent substance use. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2021. [DOI: 10.1111/cpsp.12307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kim EM, Kim H, Park E. How are depression and suicidal ideation associated with multiple health risk behaviours among adolescents? A secondary data analysis using the 2016 Korea Youth Risk Behavior Web-based Survey. J Psychiatr Ment Health Nurs 2020; 27:595-606. [PMID: 31999868 DOI: 10.1111/jpm.12610] [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] [Received: 09/10/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 12/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents' future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs. Population-based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. ABSTRACT: Introduction There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods This cross-sectional study was conducted using the 2016 Korea Youth Risk Behavior Web-based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43-4.47, 95% CI = 1.37-1.49 to 3.23-6.20) and/or who had suicidal ideation (OR = 1.33-3.19, 95% CI = 1.25-1.42 to 2.25-4.51) were more likely to engage in multiple HRBs. Discussion A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self-reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs.
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Affiliation(s)
- Eun-Mi Kim
- Department of Nursing, Sunlin University, Pohang-si, Korea
| | - Heejung Kim
- College of Nursing, Yonsei University, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Eunhee Park
- School of Nursing, University at Buffalo, Buffalo, NY, USA
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Nagata JM, Ganson KT, Griffiths S, Mitchison D, Garber AK, Vittinghoff E, Bibbins-Domingo K, Murray SB. Prevalence and correlates of muscle-enhancing behaviors among adolescents and young adults in the United States. Int J Adolesc Med Health 2020; 34:119-129. [PMID: 32549173 PMCID: PMC9972881 DOI: 10.1515/ijamh-2020-0001] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/16/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To determine the prevalence of muscle-enhancing behaviors in adolescents and young adults using a nationally representative sample in the USA and to examine differences by sex, race/ethnicity, age, socioeconomic status, body mass index, and participation in team sports. METHODS Prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I through III (1994-2002) were analyzed. Engagement in muscle-enhancing behaviors including dietary changes, exercise and weightlifting, supplement use, performance-enhancing substances, and anabolic androgenic steroids were recorded. Multiple logistic regression models using generalized estimating equations, incorporating robust standard errors with clustering by school and within persons, and using national sample weighting, were used to determine associations with muscle-enhancing behaviors across three data collection waves. RESULTS Of the 18,924 adolescents at baseline, 29.2% of males and 7.0% of females reported weight gain attempts, while 25.2% of males and 3.8% of females reported any muscle-enhancing behavior. All muscle-enhancing behaviors were more common in males compared to females (p<0.001). Among young men 18-26 years old, 15.6% reported using legal performance enhancing substances and 2.7% reported using androgenic anabolic steroids. Factors that were associated with muscle-enhancing behaviors in males across three data collection waves included Black or Hispanic/Latino race/ethnicity, age over 14 years, higher parental education, lower body mass index, and participation in team sports. CONCLUSIONS Muscle-enhancing behaviors ranging from dietary changes to supplement and androgenic anabolic steroid use are common among adolescent and young adult males. Clinicians should consider screening for muscle-enhancing behaviors in these populations.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | | | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia,Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Andrea K. Garber
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA,Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Stuart B. Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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37
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Lear MK, Perry KM, Stacy SE, Canen EL, Hime SJ, Pepper CM. Differential suicide risk factors in rural middle and high school students. Psychiatry Res 2020; 284:112773. [PMID: 31981940 DOI: 10.1016/j.psychres.2020.112773] [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] [Received: 08/07/2019] [Revised: 12/08/2019] [Accepted: 01/05/2020] [Indexed: 12/28/2022]
Abstract
Few studies have examined risk factors associated with suicidal ideation and attempts among younger adolescents compared to their high-school aged counterparts. To gain a better understanding of unique risk factors associated with suicidal ideation and attempts among middle-school aged students, the current study employed secondary data analyses on a statewide sample of middle school (6th and 8th grade; n = 7,453) and high school students (10th and 12th grade; n = 5,996) in the United States. Logistic regression analyses were used to determine the effects of fourteen empirically derived risk factors on odds of reporting suicidal ideation (SI) and suicide attempts (SA) in the past year. Results indicated unique factors associated with risk for SI and SA among middle and high school students. For middle-school aged students, female sex, lower perceptions of school safety, sensation seeking, psychological distress, bullying victimization, early initiation of drug use, and community disorganization predicted past year SI. Female sex, white race, perceptions of school safety, bullying victimization, aggregate drugs used, psychological distress, and community disorganization predicted SA. Conversely, sex, age, perceptions of school safety, and community disorganization were not associated with suicidal behavior in high school students. Developmental explanations and avenues for future research are discussed.
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Affiliation(s)
- Mary K Lear
- University of Wyoming, Laramie, WY, United States
| | | | | | - Eric L Canen
- Wyoming Survey and Analysis Center, Laramie, WY, United States
| | - Shawn J Hime
- Wyoming Survey and Analysis Center, Laramie, WY, United States
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38
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Greene N, Tomedi L, Reno J, Green D. The Role of Substance Use and Resiliency Factors on Suicidal Ideation among Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2020; 90:73-80. [PMID: 31828795 DOI: 10.1111/josh.12854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 10/23/2018] [Accepted: 04/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Suicidal ideation, an important risk factor for suicide, is strongly associated with substance use. Factors such as family cohesion, connection with friends, and social support can be protective against suicidal behaviors. The purpose of this study was to explore the association between suicidal ideation, substance use, and resiliency factors among middle school students. METHODS The 2013 New Mexico Youth Risk and Resiliency Survey provided the data for this analysis. Suicidal ideation was defined as affirmative responses to questions about thoughts of killing oneself and/or making a suicide plan. We used logistic regression to explore the association between suicidal ideation, substance use, and resiliency factors. RESULTS Overall, 23% of students reported suicidal ideation. Among girls, having a caring friend was associated with lower odds of suicidal ideation only among those not using other drugs. Among boys, having a caring friend decreased the odds of suicidal ideation regardless of substance use. CONCLUSIONS Suicidal ideation is prevalent among middle school children. Substance abuse is associated with suicidal ideation; however, individual and community support can be protective. Interventions aimed at reducing suicidal behaviors among middle school students should account for the impact of substance use and help strengthen social support.
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Affiliation(s)
- Naomi Greene
- New Mexico Department of Health, 1190 St. Francis Drive N1100, Santa Fe, NM, 87505
| | - Laura Tomedi
- New Mexico Department of Health, 1190 St. Francis Drive N1103, Santa Fe, NM, 87505
| | - Jessica Reno
- University of New Mexico School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health, MSC09 5030, 1 University of New Mexico, Albuquerque, NM, 87131-0001
| | - Dan Green
- Youth Risk and Resiliency Survey, New Mexico Department of Health, 1190 St. Francis Drive, Santa Fe, NM, 87505
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Cho MS. Use of Alcohol, Tobacco, and Caffeine and Suicide Attempts: Findings From a Nationally Representative Cross-sectional Study. J Prim Care Community Health 2020; 11:2150132720913720. [PMID: 32193974 PMCID: PMC7092647 DOI: 10.1177/2150132720913720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 02/17/2020] [Indexed: 12/29/2022] Open
Abstract
In this study, the association between students' substance use and suicide attempts in the past 1 year was examined using secondary data from the 13th Korea Risk Behavior Web-based Survey. Participants were 7th- to 12th-grade students and 50.9% were male. A binominal logistic regression analysis was used to investigate the association between past experience of substance use (alcohol, tobacco, and caffeine) and suicide attempts after controlling for sociodemographic and psychological factors. Compared with no use, daily use of alcohol (odds ratio [OR] = 8.00), caffeine (OR = 2.13), and tobacco (OR = 1.41) was associated with increased odds of suicide attempts. These results indicate that school-based suicide prevention programs should cover awareness, surveillance, and treatment referral for these 3 substances. Moreover, mental health professionals should monitor intake of these substances when evaluating risk of suicide attempts in youth.
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Lee H, Yang K, Palmer J, Kameg B, Clark L, Greene B. Substance Use Patterns Among Adolescents: A Latent Class Analysis. J Am Psychiatr Nurses Assoc 2020; 26:586-594. [PMID: 31253067 DOI: 10.1177/1078390319858658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND: Substance use among adolescents remains a major public health concern, which is correlated with mortality. AIMS: The purpose of this study was to (1) examine risk factors predisposing adolescents to substance use and (2) identify patterns of simultaneous drug exploration among adolescents. METHOD: Data (N = 15,624; collected in 2015) were drawn from the Centers for Disease Control and Prevention, National Youth Risk Behavior Survey, which is a national school-based survey of 9th- to 12th-grade students to monitor health risk behaviors. Substance use was assessed using self-reported questionnaires, and latent class analysis and logistic regression were used for data analysis. RESULTS: Five latent patterns of substance use were identified: (1) abstinent (64%); (2) 1st-step social experimenter (25%) (i.e., used alcohol, e-cigarettes, and/or marijuana); (3) 2nd-step social experimenter (6%) (i.e., used alcohol, cigarettes, e-cigarettes, marijuana, synthetic marijuana, and/or prescription pills); (4) pill experimenter (4%), (i.e., used prescription pills); (5) full experimenter (2%) (i.e., likely to use all assessed substances). Gender, race, grade, and depressive mood were strong predictors of membership in a particular substance use class. CONCLUSION: Adolescents presenting for care may possess symptoms associated with various substances beyond those being managed. Mental health nurses can leverage these results in reducing adolescent substance use through primary and secondary prevention. A longitudinal study of not only substance use patterns but also the progression to substance use disorders among adolescents is warranted.
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Affiliation(s)
- Heeyoung Lee
- Heeyoung Lee, PhD, PMHNP-BC, CRNP, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kyeongra Yang
- Kyeongra Yang, PhD, MPH, RN, CNE, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Joshua Palmer
- Joshua Palmer, BSN, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brayden Kameg
- Brayden Kameg, DNP, PMHNP-BC, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lin Clark
- Lin Clark, DNP, PMHNP-BC, Community House Mental Health Agency, Seattle, WA, USA
| | - Brian Greene
- Brian Greene, EdD, University of Pittsburgh, Pittsburgh, PA, USA
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McBee-Strayer SM, Alexy ER, Sheftall AH, Heck KM, Dombrowski-Stork CA, Bergdoll EE, Schlagbaum PM, Bridge JA. Old-for-Grade Status and Suicide Risk in U.S. High School Students. Arch Suicide Res 2020; 24:S282-S292. [PMID: 30955465 DOI: 10.1080/13811118.2019.1595797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health-risk behaviors associated with increased risk of suicide are more prevalent in old-for-grade students compared to age-appropriate-for-grade peers; however, the association between old-for-grade status and suicidal behavior is largely unknown. This study investigated sex-specific differences in suicidal ideation, planning, attempts, and other risk behaviors by old-for-grade status. Secondary analyses utilizing bivariate and logistic regression methods for complex samples were conducted using data from the 2011, 2013, and 2015 National Youth Risk Behavior Survey for 16,579 female and 17,282 male high school students in grades 9 through 11. Among both males and females, students considered old-for-grade reported increased drug use, feeling sad/hopeless, violence, sexual activity, and limited/no seatbelt use compared with their peers. Old-for-grade students were also more likely to report a suicide attempt with increased suicidal ideation and planning observed only in old-for-grade males. Associations between old-for-grade status and suicide risk-related outcomes were attenuated in both sexes after adjusting for demographic characteristics and other health-risk behaviors. Findings suggest that common risk factors (e.g., sadness, substance use) may explain increased rates of suicidal behaviors in old-for-grade students.
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Zeller MH, Reiter-Purtill J, Jenkins TM, Kidwell KM, Bensman HE, Mitchell JE, Courcoulas AP, Inge TH, Ley SL, Gordon KH, Chaves EA, Washington GA, Austin HM, Rofey DL. Suicidal thoughts and behaviors in adolescents who underwent bariatric surgery. Surg Obes Relat Dis 2019; 16:568-580. [PMID: 32035828 DOI: 10.1016/j.soard.2019.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/18/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Extant literature warns of elevated suicide risks in adults postbariatric surgery, making understanding risks for adolescent patients imperative. OBJECTIVES To examine prevalence and predictors/correlates of suicidal thoughts and behaviors (STBs) in adolescents with severe obesity who did/did not undergo bariatric surgery from presurgery/baseline to 4 years postsurgery. SETTING Five academic medical centers. METHODS Using a prospective observational design, surgical adolescents (n = 153; 79% female, 65% white, mean [M]age = 17 yr, Mbody mass index[BMI] = 52 kg/m2) and nonsurgical comparators (n = 70; 80% female, 54% white, Mage = 16 yr, MBMI = 47 kg/m2) completed psychometrically sound assessments at presurgery/baseline and postsurgery years 2 and 4 (year 4: n = 117 surgical [MBMI = 38 kg/m2], n = 56 nonsurgical [MBMI = 48 kg/m2]). RESULTS For the surgical group, rates of STBs were low (year 2 [1.3%-4.6%]; year 4 [2.6%-7.9%], similar to national base rates. Groups did not differ on a year 4 postsurgical STBs (post-STBs) composite (post-STBs: ideation/plan/attempt; n = 18 surgical [16%], n = 10 nonsurgical [18%]; odds ratio = .95, P = .90). For the surgical group, predictors/correlates identified within the broader suicide literature (e.g., psychopathology [P < .01], victimization [P < .05], dysregulation [P < .001], drug use [P < .05], and knowing an attemptor/completer [P < .001]) were significantly associated with post-STBs. Surgery-specific factors (e.g., percent weight loss, weight satisfaction) were nonsignificant. Of those reporting a lifetime attempt history at year 4, only a minority (4/13 surgical, 3/9 nonsurgical) reported a first attempt during the study period. Of 3 decedents (2 surgical, 1 nonsurgical), none were confirmed suicides. CONCLUSIONS The present study indicates that undergoing bariatric surgery in adolescence does not heighten (or lower) risk of STB engagement across the initial 4 years after surgery. Suicide risks present before surgery persisted, and also newly emerged in a subgroup with poorer psychosocial health.
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Affiliation(s)
- Meg H Zeller
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Todd M Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Katherine M Kidwell
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Heather E Bensman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Anita P Courcoulas
- Division of Minimally Invasive Bariatric Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Thomas H Inge
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado
| | - Sanita L Ley
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Eileen A Chaves
- Department of Psychiatry and Behavioral Health, Nationwide Children's Hospital Medical Center, Columbus, Ohio
| | - Gia A Washington
- Department of Psychology, Texas Children's Hospital, Houston, Texas
| | - Heather M Austin
- Department of Pediatrics, Children's of Alabama, Birmingham, Alabama
| | - Dana L Rofey
- Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Yu B, Chen X. Age and Birth Cohort-Adjusted Rates of Suicide Mortality Among US Male and Female Youths Aged 10 to 19 Years From 1999 to 2017. JAMA Netw Open 2019; 2:e1911383. [PMID: 31517968 PMCID: PMC6745055 DOI: 10.1001/jamanetworkopen.2019.11383] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Strategic planning to curb increasing suicide rate among US youths requires unbiased measures of suicide mortality, as the unadjusted suicide mortality rates conventionally used in describing time trends and sex patterns are confounded by the differences in chronological age and year of birth. OBJECTIVE To measure time trends and sex differences in suicide mortality among US youths using age and birth cohort (age-cohort)-adjusted rates. DESIGN, SETTING, AND PARTICIPANTS This population-based multiyear cross-sectional study of US youths aged 10 to 19 years was a secondary analysis of the suicide data for January 1, 1999, to December 31, 2017, derived from the Wide-Ranging Online Data for Epidemiologic Research, a database prepared by the US Centers for Disease Control and Prevention to promote research. Data analysis was conducted from May 24 to May 27, 2019. MAIN OUTCOMES AND MEASURES Age-cohort-adjusted suicide mortality rates by year and sex were used as the main outcomes. These adjusted rates were calculated based on the period effect estimated with the age-period-cohort (APC) modeling method. Participants' age, year of birth, and the year when suicide occurred were used as time-related risk factors. RESULTS Age-cohort-adjusted suicide mortality rates were estimated successfully by year and by sex. The adjusted rates were obtained after controlling for a V-shaped cohort effect and a curved age effect that also differed by sex. The unadjusted suicide mortality rate for male youths increased from 7.4 per 100 000 in 1999 to 10.7 per 100 000 in 2017, while the adjusted rate increased from 4.9 per 100 000 in 1999 to 8.7 per 100 000 in 2017. The unadjusted suicide mortality rates for female youths were 1.6 per 100 000 in 1999 and 3.5 per 100 000 in 2017, while the adjusted rates were 1.7 per 100 000 in 1999 and 4.2 per 100 000 in 2017. CONCLUSIONS AND RELEVANCE Findings of this study indicate a more rapid increase and smaller male-female difference in suicide rates among US youths since 1999 than those shown by the unadjusted suicide mortality rates. The adjusted rates provide unbiased data that are needed for evidence-based decision-making and strategies to curb the increasing suicide rates among US youths.
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Affiliation(s)
- Bin Yu
- Department of Epidemiology, University of Florida, Gainesville
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville
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Physical and psychosocial factors associated with psychostimulant use in a nationally representative sample of French adolescents: Specificities of cocaine, amphetamine, and ecstasy use. Addict Behav 2019; 92:208-224. [PMID: 30658258 DOI: 10.1016/j.addbeh.2018.11.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE Patterns of psychostimulant (PST) use, psychological and physical factors, and family relationships were investigated in a nationally representative sample of adolescents. The differences between users of cocaine (Cc), ecstasy/MDMA, and amphetamine (EA) were analyzed, taking into account gender differences. METHODS Substance use, psychological factors (lifetime suicide attempts, suicidal thoughts in the previous year, visits to a mental health professional), physical factors (health and body shape perceptions (BSP), body mass index (BMI)), and family relationships (existence of disagreements with parents, relationships with mother and father) were investigated in 26,351 17-year-old French adolescents. RESULTS Lifetime suicidal behavior was strongly associated with EA use only. Suicidal ideation in the previous year was associated with Cc use among both boys and girls and associated with EA use among girls. Compared to Cc users, more EA users were overweight, while more Cc users were underweight compared to EA users. BSP, BMI, and EA use were related in girls only. Having a good or very good relationship with both mother and father was negatively associated with Cc use in boys and girls. Girls who had a good or very good relationship with their fathers seemed to be less prone to use EA. Boys with a good or very good relationship with their mothers seemed to be less prone to use EA. CONCLUSION The results of the present study could serve as a basis for prevention and harm reduction strategies/programs targeting youth use and for the adaptation of these strategies/programs according to substance and gender.
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Ruch DA, Sheftall AH, Schlagbaum P, Fontanella CA, Campo JV, Bridge JA. Characteristics and Precipitating Circumstances of Suicide Among Incarcerated Youth. J Am Acad Child Adolesc Psychiatry 2019; 58:514-524.e1. [PMID: 30768395 PMCID: PMC9721273 DOI: 10.1016/j.jaac.2018.07.911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/25/2018] [Accepted: 08/15/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Studies show incarcerated youth are at increased risk for suicidal behavior, yet little is known about factors associated with suicide for this population. Using a nationally representative sample, this study examined characteristics and precipitating circumstances of suicide in incarcerated youth decedents compared with youth suicide decedents in the general population. METHOD Data were analyzed for suicide decedents 10- to 24-years-old (N = 10,126) in the United States from 2003 through 2012 from the National Violent Death Reporting System. Logistic regression compared precipitating circumstances of suicide for incarcerated youth decedents and those not in custody. Details on suicide deaths in detained youth were captured from coroner/medical examiner and law enforcement reports associated with each incident. RESULTS Most youth suicide decedents were older, white, and male regardless of incarceration status. Incarcerated youth suicide decedents were more likely to die by hanging, strangulation, or suffocation and less likely to disclose suicide intent, leave a suicide note, or exhibit depressive symptoms compared with those not in custody. Additional risk factors for suicide were not significantly different between youth decedents in custody and those not in custody, suggesting that unique aspects of the incarceration environment could be associated with an increased risk of suicide. CONCLUSION Study findings highlight the need for early suicide risk detection and developmentally relevant interventions tailored for youth in correctional settings. Future efforts should include evaluation studies to support suicide prevention programs designed for incarcerated youth and research that examines distinctive factors associated with suicidal behavior in youth in custody.
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Affiliation(s)
- Donna A. Ruch
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Arielle H. Sheftall
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Paige Schlagbaum
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - Cynthia A. Fontanella
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
| | - John V. Campo
- Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown
| | - Jeffrey A. Bridge
- Research Institute at Nationwide Children’s Hospital Center for Innovation of Pediatric Practice, Wexner Medical Center, The Ohio State University, Columbus
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Franco M, Carter S. Discrimination from family and substance use for multiracial individuals. Addict Behav 2019; 92:203-207. [PMID: 30658257 DOI: 10.1016/j.addbeh.2019.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/24/2018] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
Whereas Multiracial people exhibit heightened rates of substance use, existing research has yet to account for why. The current study examines whether Multiracial people's experiences of discrimination from family may explain their substance use behaviors, and furthermore, whether compromised mental health indirectly explains relationships between familial discrimination and substance use. Online cross-sectional survey data was collected from (N = 466) Multiracial participants. Negative binomial regression analysis indicated that discrimination from family predicted drug use above and beyond general discrimination. Results of bootstrapping analysis revealed that the pathway from discrimination from family to drug use is partially explained by anxiety and depressive symptoms. The implications of these findings for addressing heightened rates of substance abuse among the Multiracial population are discussed.
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Affiliation(s)
- Marisa Franco
- Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30303, United States.
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States
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Karanikola M, Zisimou P, Nystazaki M, Koutrouba A, Severinsson E. Association between illegal use of substances and suicidal behavior in school students: An integrative review of empirical data. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2019; 32:80-101. [PMID: 30912247 DOI: 10.1111/jcap.12228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Investigation of the association between type of suicidal behavior and type and frequency of illegal use of substances (IUS) among school students (aged between 12 and 18 years), with a focus on gender differences. DESIGN AND METHODS A systematic review in PubMed, CINAHL, PsychINFO, and Scopus was performed. Identified articles were published between 2007 and 2018. RESULTS Twenty empirical studies confirmed the association between IUS and suicidality, strongly differentiated between males and females, highlighting the importance of gender-specific mediating factors. CONCLUSIONS Mental health nurses need to document gender factors, frequency, and motivation of IUS when screening adolescents experiencing suicidal behavior and IUS.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Prodromoula Zisimou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Nystazaki
- Psychiatric Clinic of Ag. Anargiroi Hospital, Department of Nursing, National & Kapodistrian University of Athens, Athens, Greece
| | - Anna Koutrouba
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Elisabeth Severinsson
- Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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Sellers CM, Iriarte ADV, Battalen AW, O’Brien KHM. Alcohol and marijuana use as daily predictors of suicide ideation and attempts among adolescents prior to psychiatric hospitalization. Psychiatry Res 2019; 273:672-677. [PMID: 31207851 PMCID: PMC9262037 DOI: 10.1016/j.psychres.2019.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Little research has been conducted on alcohol use, marijuana use, and suicide ideation and attempts on a daily level, and specifically among adolescents prior to inpatient hospitalization. The purpose of this study was to examine the within (over time) and between (between adolescents) effects of alcohol use and marijuana use on suicide ideation and attempts. METHODS Participants included 50 adolescents (80% female; Mage = 15.8). All participants reported drinking alcohol in the prior three months and were receiving treatment in an inpatient psychiatric hospital. Random and mixed-effect models were used to test study hypotheses. RESULTS Results from the random effect model indicated that alcohol use, marijuana use, hospitalization and sexual orientation were significant predictors of suicide attempts. Results from the mixed-effect model indicated that marijuana use, hospitalization, and sexual orientation were significant predictors of suicide ideation. CONCLUSIONS Study findings extend current knowledge about the longitudinal and day-to-day relationship between alcohol and marijuana use and suicide ideation and attempts. Results underscore the importance of addressing alcohol and marijuana use in interventions with suicidal adolescents, recognizing that sexual minority youth may be at elevated risk for suicide ideation.
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Affiliation(s)
- Christina M. Sellers
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Corresponding author at: Boston Children’s Hospital, 300 Longwood Ave, Boston, MA, USA. (C.M. Sellers)
| | - Antonia Diaz-Valdes Iriarte
- Boston College, School of Social Work, 140 Commonwealth Ave Chestnut Hill, MA 02467, USA,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Oficina 1305, Las Condes, Santiago 750000 Chile
| | - Adeline Wyman Battalen
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA
| | - Kimberly H. McManama O’Brien
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Education Development Center, Department of Innovation in Practice and Technology, 43 Foundry Ave Waltham, MA 02453, USA,Harvard Medical School, Department of Psychiatry, 25 Shattuck St Boston, MA 02115, USA
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Beverly HK, Castro Y, Opara I. Age of First Marijuana Use and Its Impact on Education Attainment and Employment Status. JOURNAL OF DRUG ISSUES 2019; 49:228-237. [PMID: 31341332 DOI: 10.1177/0022042618823007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
With the increased prevalence of marijuana use among youth, the increase in state legalization, and changing social norms in the United States, it is important to understand the long-term impact of marijuana use initiation. This study examined whether age of first marijuana use is associated with educational attainment and employment status. Data from 5,988 adults aged 26 to 49 years who participated in the 2015 National Survey on Drug Use and Health were used in the current study. Logistic regression analyses were used to examine the odds of graduating from high school and being employed. Controlling for demographics, persons with late-early first use had significantly higher odds of graduating from high school and being employed compared with persons with early first use. Results underscore the importance of early prevention for youth aged 15 and younger and have implications for intervention and policy development.
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50
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Fisher S, Wheeler LA, Arora PG, Chaudry J, Barnes-Najor J. Ethnic identity and substance use in multiracial youth: the moderating role of support networks. Subst Use Misuse 2019; 54:1417-1428. [PMID: 31062627 PMCID: PMC6546508 DOI: 10.1080/10826084.2019.1573834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Substance use in multiracial adolescents exceeds rates identified in the general population. Despite this fact, there is limited research examining risk and protective factors for multiracial substance use. Objectives: The current study examined the moderating effect of social support on the relationship between ethnic identity and substance use in a sample of multiracial adolescent youth. Methods: Multiracial youth (N = 523) completed a survey that asked questions related to their ethnic identity, perceived social support, and substance use. A series of path analyses were conducted to test the hypothesized relationships between ethnic identity, social support, and substance use. Results: Analyses indicated that ethnic affirmation was negatively related to frequency of, but not quantity of substance use. Teacher support was negatively related to both frequency and quantity of substance use, while parent support was only related to frequency. Further, teacher and parent support emerged as moderators of ethnic affirmation and frequency and quantity of substance use respectively. Conclusions/Importance: Our findings add to the current understandings of the relationship between ethnic identity, social support, ethnic identity, and substance use among the understudied multiracial adolescent population.
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Affiliation(s)
- Sycarah Fisher
- a Department of Educational, School, and Counseling Psychology , University of Kentucky , Lexington , KY, USA
| | - Lorey A Wheeler
- b Youth, Families and Schools, Nebraska Center for Research on Children , University of Nebraska-Lincoln , Lincoln , NE, USA
| | - Prerna G Arora
- c Teachers College , Columbia University , New York , NY, USA
| | - Joshua Chaudry
- a Department of Educational, School, and Counseling Psychology , University of Kentucky , Lexington , KY, USA
| | - Jessica Barnes-Najor
- d Community Evaluation and Research Collaborative , Michigan State University , East Lansing , MI, USA
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