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Lange S, Llamosas-Falcón L, Kim KV, Lasserre AM, Orpana H, Bagge CL, Roerecke M, Rehm J, Probst C. A dose-response meta-analysis on the relationship between average amount of alcohol consumed and death by suicide. Drug Alcohol Depend 2024; 260:111348. [PMID: 38820908 DOI: 10.1016/j.drugalcdep.2024.111348] [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: 02/27/2024] [Revised: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND To determine whether sub-clinical levels of drinking may contribute to suicide risk, and whether the risk differs by sex, we aimed to evaluate the relationship between average amount of alcohol consumed per day and death by suicide. METHODS A systematic literature search was performed in Embase, Medline, PsycINFO, PubMed, and Web of Science from database inception up to April 27, 2022. The search strategies incorporated a combination of medical subject headings and keywords for "alcohol use" and "suicide". One-stage dose-response meta-analyses using a restricted maximum likelihood random-effect estimator were conducted to explore the relationship between average alcohol volume consumed and suicide, by sex. Three different shapes of the dose-response relationship-linear (on the log-scale), quadratic, and restrictive cubic splines-were tested. RESULTS A total of eight studies were included (three studies for females (n=781,205), and eight studies for males (n=1,215,772)). A linear dose-response relationship between average alcohol volume consumed and the log-risk of suicide was identified for both males and females. For males and females, a relative risk (RR) of 1.11 (95% CI: 1.05, 1.18) and 1.64 (95% CI: 1.07, 2.51) for suicide when consuming an average of 10 g of pure alcohol per day compared to lifetime abstention, 1.38 (95% CI: 1.14, 1.66) and 4.39 (95% CI: 1.21, 15.88) for 30g/day, and 1.71 (95% CI: 1.25, 2.33) and 11.75 (95% CI: 1.38, 100.33) for 50g/day, respectively. CONCLUSIONS As consumption increases, the risk of suicide increases proportionally. The risk of suicide associated with average daily alcohol consumption may be elevated for females, compared with males. Albeit, more research is needed, particularly among females.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.
| | - Laura Llamosas-Falcón
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kawon V Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada
| | - Aurélie M Lasserre
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, rue du Bugnon 23, Lausanne 1011, Switzerland
| | - Heather Orpana
- Public Health Agency of Canada, 785 Carling Ave., Ottawa, ON K1A 0K9, Canada; School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada
| | - Courtney L Bagge
- Department of Psychiatry, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109, United States; Center for Clinical Management Research, Department of Veterans Affairs, 2215 Fuller Rd, Ann Arbor, MI 48105, United States
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada; Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Roc Boronat Street 81-95, Barcelona, Catalonia 08005, Spain; Zentrum für Interdisziplinäre Suchtforschung (ZIS), Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, ON M5S 2S1, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
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2
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Nagashima K, Yasuno N, Watanabe M. Creating and evaluating the score to assess overdose: the OD score. BMC Emerg Med 2024; 24:5. [PMID: 38185623 PMCID: PMC10773033 DOI: 10.1186/s12873-023-00923-6] [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: 06/19/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND During disasters (including epidemics such as coronavirus disease 2019), the capacity of emergency departments is exceeded, thereby hindering the administration of appropriate lifesaving measures. Furthermore, the number of overdose patients increases because of the stress overload during emergency situation. The fact that overdose patients are forced to be transported to medical facilities that do not typically treat them is becoming worrisome. Moreover, there is no definitive score for overdose. This study aimed to create a patient-specific scoring system to assess overdose. METHODS This was a retrospective single-center study. The evidence-based OD score was evaluated on a scale of 0-15. Further, logistic analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the score. RESULTS Overall, 262 patients (including 118 overdose patients) receiving care at the intensive care unit of Japan's Teikyo University Hospital in 2021 were targeted. Regarding the total OD score, ROC analysis revealed a cutoff of 8 (area under the curve [AUC]: 0.99, 95% confidence interval [CI]: 0.980-0.997, sensitivity: 0.95, specificity: 0.95, p < 0.05), which was considered to indicate an overdose. Of the items evaluated in the OD score, the scenario at the location of the patient's discovery (adjusted odds ratio [AOR]: 16.8, 95% CI: 5.0-255.9, p = 0.002) and recent experience of mental anxiety (AOR: 55.7, 95% CI: 2.8-5399.5, p = 0.03) significantly predicted an overdose in multivariable logistic regression analysis. External validation revealed that the OD score could also identify overdose in patients treated in a cohort from 2022 (average cutoff: 8.6, average AUC: 1.0, p < 0.0001). CONCLUSIONS The OD score could accurately assess overdose patients. Medical facilities that do not frequently address overdose patients will benefit from the use of this score.
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Affiliation(s)
- Kazuki Nagashima
- Laboratory of Practical Pharmacy, Graduate School and Faculty of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan.
- Laboratory of Clinical Pharmaceutics, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Nobuhiro Yasuno
- Laboratory of Hospital Pharmacy, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Machiko Watanabe
- Laboratory of Clinical Pharmaceutics, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
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Isaacs JY, Smith MM, Sherry SB, Seno M, Moore ML, Stewart SH. Alcohol use and death by suicide: A meta-analysis of 33 studies. Suicide Life Threat Behav 2022; 52:600-614. [PMID: 35181905 DOI: 10.1111/sltb.12846] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/02/2021] [Accepted: 01/21/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Decades of research show an association between alcohol use and death by suicide. However, findings on the temporal link between alcohol use and death by suicide are unclear. In the most comprehensive meta-analysis on the topic to date, we analyzed data from longitudinal studies to determine if alcohol use is a risk for death by suicide. We also explored moderators to uncover conditions where the alcohol use-suicide link is strengthened/weakened. METHODS Our literature search of six databases yielded 33 eligible studies involving 10,253,101 participants (community, psychiatric, and military samples). RESULTS Alcohol use was associated with a 94% increase in the risk of death by suicide. Specifically, random-effects meta-analysis revealed alcohol use displayed small-to-large significant risk and odds ratios with suicide for quantity of alcohol use and alcohol use diagnosis/alcohol-related problems. Meta-regression generally indicated larger effect sizes for studies with a higher percentage of women, younger age, unadjusted estimates, longer follow-up periods, military samples, and higher frequencies and quantities of alcohol use (relative to drinker/non-drinker status). CONCLUSION Our study highlights alcohol use as a substantive risk factor for death by suicide and underscores the importance of monitoring alcohol use among suicidal individuals and screening for suicidality among heavier alcohol users.
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Affiliation(s)
- Jason Y Isaacs
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin M Smith
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin Seno
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mackenzie L Moore
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
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4
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Kim SW, Park WY, Kim H, Jhon M, Kim JW, Kang HJ, Kim SY, Ryu S, Lee JY, Shin IS, Kim JM. Development of a Checklist for Predicting Suicidality Based on Risk and Protective Factors: The Gwangju Checklist for Evaluation of Suicidality. Psychiatry Investig 2022; 19:470-479. [PMID: 35753686 PMCID: PMC9233948 DOI: 10.30773/pi.2022.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of the study was to develop a checklist for mental health clinicians to predict and manage suicidality. METHODS A literature review of the risk and protective factors for suicide was conducted to develop a checklist for evaluating suicidality. RESULTS The fixed risk factors included sex (male), age (older individuals), history of childhood adversity, and a family history of suicide. Changeable risk factors included marital status (single), economic status (poverty), physical illness, history of psychiatric hospitalization, and history of suicide attempts. Recent discharge from a mental hospital and a recent history of suicide attempts were also included. Manageable risk factors included depression (history and current), alcohol problems (frequent drinking and alcohol abuse), hopelessness, agitation, impulsivity, impaired reality testing, and command hallucinations. Protective factors included responsibility to family, social support, moral objections to suicide, religiosity, motivation to get treatment, ability to cope with stress, and a healthy lifestyle. A final score was assigned based on the sum of the risk and protective factor scores. CONCLUSION We believe that the development of this checklist will help mental health clinicians to better assess those at risk for suicidal behavior. Further studies are necessary to validate the checklist.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Woo-Young Park
- Department of Psychiatry, Gwangju Veterans Hospital, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyoung Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Metropolitan Mental Health Welfare Center, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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Tamura T, Wakai K, Lin Y, Tamakoshi A, Utada M, Ozasa K, Sugawara Y, Tsuji I, Ono A, Sawada N, Tsugane S, Ito H, Nagata C, Kitamura T, Naito M, Tanaka K, Shimazu T, Mizoue T, Matsuo K, Inoue M. Alcohol intake and stomach cancer risk in Japan: A pooled analysis of six cohort studies. Cancer Sci 2021; 113:261-276. [PMID: 34689390 PMCID: PMC8748227 DOI: 10.1111/cas.15172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022] Open
Abstract
The association between alcohol intake and stomach cancer risk remains controversial. We undertook a pooled analysis of data from six large-scale Japanese cohort studies with 256 478 participants on this topic. Alcohol intake as ethanol was estimated using a validated questionnaire. The participants were followed for incidence of stomach cancer. We calculated study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for stomach cancer according to alcohol intake using a Cox regression model. Summary HRs were estimated by pooling the study-specific HRs using a random-effects model. During 4 265 551 person-years of follow-up, 8586 stomach cancer cases were identified. In men, the multivariate-adjusted HRs (95% CIs) of stomach cancer were 1.00 (0.87-1.15) for occasional drinkers, and 1.00 (0.91-1.11) for <23 g/d, 1.09 (1.01-1.18) for 23 to <46 g/d, 1.18 (1.09-1.29) for 46 to <69 g/d, 1.21 (1.05-1.39) for 69 to <92 g/d, and 1.29 (1.11-1.51) for ≥92 g/d ethanol in regular drinkers compared with nondrinkers. In women, the multivariate-adjusted HRs were 0.93 (0.80-1.08) for occasional drinkers, and 0.85 (0.74-0.99) for <23 g/d, and 1.22 (0.98-1.53) for ≥23 g/d in regular drinkers compared with nondrinkers. The HRs for proximal and distal cancer in drinkers vs nondrinkers were 1.69 (1.15-2.47) and 1.24 (0.99-1.55) for ≥92 g/d in men, and 1.60 (0.76-3.37) and 1.18 (0.88-1.57) for ≥23 g/d in women, respectively. Alcohol intake increased stomach cancer risk in men, and heavy drinkers showed a greater point estimate of risk for proximal cancer than for distal cancer.
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Affiliation(s)
- Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ayami Ono
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Japan.,Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tetsuhisa Kitamura
- Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mamami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Masaoka H, Matsuo K, Oze I, Ito H, Naito M, Wada K, Nagata C, Nakayama T, Kitamura Y, Sadakane A, Tamakoshi A, Tsuji I, Sugawara Y, Sawada N, Mizoue T, Inoue M, Tanaka K, Tsugane S, Shimazu T. Alcohol Drinking and Bladder Cancer Risk From a Pooled Analysis of Ten Cohort Studies in Japan. J Epidemiol 2020; 30:309-313. [PMID: 31204364 PMCID: PMC7280052 DOI: 10.2188/jea.je20190014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/28/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The association of alcohol drinking with bladder cancer risk remains unclear in East Asian populations. Aldehyde dehydrogenase 2 (ALDH2) enzyme oxidizes alcohol-metabolized carcinogenic acetaldehyde into acetate. It is well known that the inactive ALDH2 carriers, specific to East Asian populations, have an increased risk of several cancer types because of increased exposure to acetaldehyde after alcohol consumption. The aim of this study was to examine the association between alcohol drinking and bladder cancer risk using data from ten population-based prospective cohort studies in Japan, where approximately 40% of the population has inactive ALDH2 enzyme. METHODS We analyzed 340,497 Japanese participants with average follow-up of 13.4 years. The association between alcohol drinking and bladder cancer risk was evaluated using Cox regression models within each study, and random-effects models were used to estimate pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs). RESULTS During 4,729,071 person-years, 936 men and 325 women were newly diagnosed with bladder cancer. Our results showed no evidence of significant association between alcohol drinking and bladder cancer risk even among men who consumed alcohol of ≥69 g/week, with HR of 1.02 (95% CI, 0.79-1.33). The null result was observed consistently among women. CONCLUSIONS Our findings do not support an association between alcohol drinking and bladder cancer risk in the Japanese, at least without consideration of the polymorphisms of alcohol-metabolizing enzymes.
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Affiliation(s)
- Hiroyuki Masaoka
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute
- Department of Urology, Graduate School of Medical Sciences, Kyushu University
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute
- Department of Epidemiology, Nagoya University Graduate School of Medicine
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute
| | - Hidemi Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine
| | - Tomio Nakayama
- Screening Assessment and Management Group, Center for Public Health Sciences, National Cancer Center
| | - Yuri Kitamura
- Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
| | - Yumi Sugawara
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Tetsuya Mizoue
- Department of Epidemiology and International Health, International Clinical Research Center, National Center for Global Health and Medicine
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
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Abstract
Objectives: Alcohol use has several consequences and is one of the variables that increase risk of suicide. This meta-analysis was performed using cohort studies to clarify the association of alcohol use and suicide.Method: Scientific sources were reviewed regarding the keywords. After screening, thirty cohort studies were identified for the meta-analysis. The analysis was performed based on the random effects and subsequent analysis of the subgroups, based on various variables.Result: Analysis of the results showed that there is a relationship between alcohol use and suicide. Risk Ratio (RR) between alcohol use and suicide was 1.65. In men, pooled RR was 1.56 with 95% CI = 1.20-2.03, and in women, the pooled RR was equal to 1.40 with 95% CI = 1.11-1.77.Conclusion: Overall, the findings indicate that alcohol use is a risk factor for suicide. Therefore, it seems that prevention and control of alcohol use can be effective in promoting mental health.
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Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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8
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Kim SW, Jhon M, Kim M, Paik JW, Kim JM, Yoon JS. A social psychiatric approach to suicide prevention. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2019. [DOI: 10.5124/jkma.2019.62.2.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- MindLink, Gwangju Bukgu Mental Health and Welfare Center, Gwangju, Korea
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Gwangju Metropolitan Mental Health and Welfare Center, Gwangju, Korea
| | - Mina Kim
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
- Department of Nursing, Graduate School, Chonnam National University, Gwangju, Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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9
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Yi SW, Jung M, Kimm H, Sull JW, Lee E, Lee KO, Ohrr H. Usual alcohol consumption and suicide mortality among the Korean elderly in rural communities: Kangwha Cohort Study. J Epidemiol Community Health 2016; 70:778-83. [PMID: 26888918 PMCID: PMC4975804 DOI: 10.1136/jech-2015-206849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/28/2016] [Indexed: 11/25/2022]
Abstract
Background The evidence from prospective studies on whether greater usual alcohol consumption is associated with a higher risk of death by suicide in the general population is inconclusive. Methods 6163 participants (2635 men; 3528 women) in a 1985 survey among rural residents in Korea aged 55 years and above were followed until 2008. A Cox model was used to calculate HRs of suicide death after adjustment for demographic, socioeconomic and health-related confounders. Results 37 men and 24 women died by suicide. Elderly persons who consumed alcohol daily, 70 g alcohol (5 drinks) or more per drinking day, or 210 g alcohol (15 drinks) or more per week had higher suicide mortality (p<0.05), compared with non-drinkers. An increase of one drinking day per week (HR=1.17, 95% CI 1.05 to 1.31), 70 g (5 drinks) additional alcohol intake per drinking day (HR=1.38, 95% CI 1.13 to 1.70), and 140 g (10 drinks) additional alcohol intake per week was associated with a 17%, 38% and 12% higher risk of suicide death, respectively. Women had a higher relative risk of suicide death associated with alcohol consumption, compared with men. Conclusions A greater frequency and amount of usual alcohol consumption was linearly associated with higher suicide death. Given the same amount of alcohol consumption, women might have a higher relative risk of suicide than men. Our findings support ‘the lower the better’ for alcohol intake, no protective effect of moderate alcohol consumption, and a sex-specific guideline (lower alcohol threshold for women) as actions to prevent suicide death.
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Affiliation(s)
- Sang-Wook Yi
- Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea Institute for Clinical and Translational Research, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - Myoungjee Jung
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Heejin Kimm
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Jae-Woong Sull
- Department of Biomedical Laboratory Science, Eulji University College of Health Science, Sungnam, Republic of Korea
| | - Eunsook Lee
- Department of Nursing, Sangmyung University, Cheonan, Republic of Korea
| | - Kwang Ok Lee
- Department of Nursing, Sangmyung University, Cheonan, Republic of Korea
| | - Heechoul Ohrr
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Nanri A, Mizoue T, Poudel-Tandukar K, Noda M, Kato M, Kurotani K, Goto A, Oba S, Inoue M, Tsugane S. Dietary patterns and suicide in Japanese adults: the Japan Public Health Center-based Prospective Study. Br J Psychiatry 2013; 203:422-7. [PMID: 24115342 DOI: 10.1192/bjp.bp.112.114793] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although dietary patterns have been linked to depression, a frequently observed precondition for suicide, no study has yet examined the association between dietary patterns and suicide risk. AIMS To prospectively investigate the association between dietary patterns and death from suicide. METHOD Participants were 40 752 men and 48 285 women who took part in the second survey of the Japan Public Health Center-based Prospective Study (1995-1998). Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of suicide from the fourth year of follow-up to December 2005 were calculated. RESULTS Among both men and women, a 'prudent' dietary pattern characterised by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweed and fish was associated with a decreased risk of suicide. The multivariable-adjusted hazard ratio of suicide for the highest v. lowest quartiles of the dietary pattern score was 0.46 (95% CI 0.28-0.75) (P for trend, 0.005). Other dietary patterns (Westernised and traditional Japanese) were not associated with suicide risk. CONCLUSIONS Our findings suggest that a prudent dietary pattern may be associated with a decreased risk of death from suicide.
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Affiliation(s)
- Akiko Nanri
- Akiko Nanri, PhD, Tetsuya Mizoue, MD, PhD, Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo; Kalpana Poudel-Tandukar, PhD, Waseda Institute for Advanced Study (WIAS), Waseda University, Tokyo; Mitsuhiko Noda, MD, PhD, Department of Diabetes and Metabolic Medicine, National Center for Global Health and Medicine, Tokyo; Masayuki Kato, MD, PhD, Japan Foundation for the Promotion of International Medical Research Cooperation, Tokyo; Kayo Kurotani, PhD, Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo; Atsushi Goto, MD, PhD, Department of Diabetes and Metabolic Medicine, National Center for Global Health and Medicine, Tokyo; Shino Oba, PhD, Department of Health Promotion, National Institute of Public Health, Saitama; Manami Inoue, MD, PhD, Shoichiro Tsugane, MD, PhD, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
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Social and geographical inequalities in suicide in Japan from 1975 through 2005: a census-based longitudinal analysis. PLoS One 2013; 8:e63443. [PMID: 23671679 PMCID: PMC3646025 DOI: 10.1371/journal.pone.0063443] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 04/05/2013] [Indexed: 01/11/2023] Open
Abstract
Background Despite advances in our understanding of the countercyclical association between economic contraction and suicide, less is known about the levels of and changes in inequalities in suicide. The authors examined social and geographical inequalities in suicide in Japan from 1975 through 2005. Methods Based on quinquennial vital statistics and census data, the authors analyzed the entire population aged 25–64 years. The total number of suicides was 75,840 men and 30,487 women. For each sex, the authors estimated odds ratios (ORs) and 95% credible intervals (CIs) for suicide using multilevel logistic regression models with “cells” (cross-tabulated by age and occupation) at level 1, seven different years at level 2, and 47 prefectures at level 3. Prefecture-level variance was used as an estimate of geographical inequalities in suicide. Results Adjusting for age and time-trends, the lowest odds for suicide was observed among production process and related workers (the reference group) in both sexes. The highest OR for men was 2.52 (95% CI: 2.43, 2.61) among service workers, whereas the highest OR for women was 9.24 (95% CI: 7.03, 12.13) among security workers. The degree of occupational inequalities increased among men with a striking change in the pattern. Among women, we observed a steady decline in suicide risk across all occupations, except for administrative and managerial workers and transport and communication workers. After adjusting for individual age, occupation, and time-trends, prefecture-specific ORs ranged from 0.76 (Nara Prefecture) to 1.36 (Akita Prefecture) for men and from 0.79 (Kanagawa Prefecture) to 1.22 (Akita Prefecture) for women. Geographical inequalities have increased primarily among men since 1995. Conclusions The present findings demonstrate a striking temporal change in the pattern of social inequalities in suicide among men. Further, geographical inequalities in suicide have considerably increased across 47 prefectures, primarily among men, since 1995.
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Milner A, Hjelmeland H, Arensman E, Leo DD. Social-Environmental Factors and Suicide Mortality: A Narrative Review of over 200 Articles. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/sm.2013.32021] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kim SW, Kim JM, Shin IS, Yoon JS. Suicide and crisis intervention. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2012. [DOI: 10.5124/jkma.2012.55.4.341] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
- Gwangju Buk-gu Community Mental Health Center, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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Schneider B, Baumert J, Schneider A, Marten-Mittag B, Meisinger C, Erazo N, Hammer GP, Ladwig KH. The effect of risky alcohol use and smoking on suicide risk: findings from the German MONICA/KORA-Augsburg Cohort Study. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1127-32. [PMID: 20857085 DOI: 10.1007/s00127-010-0287-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Accepted: 09/03/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplified effect on risk prediction has not been investigated so far. METHODS In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 25-74 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption. RESULTS After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.14-4.37) and for smoking (SMR = 2.30; 95% CI 1.36-3.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.07-9.46) was observed for smokers with risky alcohol consumption. CONCLUSIONS The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness.
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Affiliation(s)
- Barbara Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Johann Wolfgang Goethe-University of Frankfurt/Main, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt/Main, Germany.
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NORSTRÖM THOR, STICKLEY ANDREW, SHIBUYA KENJI. The importance of alcoholic beverage type for suicide in Japan: A time-series analysis, 1963-2007. Drug Alcohol Rev 2011; 31:251-6. [DOI: 10.1111/j.1465-3362.2011.00300.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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DiStefano AS. Suicidality and self-harm among sexual minorities in Japan. QUALITATIVE HEALTH RESEARCH 2008; 18:1429-1441. [PMID: 18689528 DOI: 10.1177/1049732308322605] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In this study, I used ethnographic methods to examine suicidality and nonsuicidal self-harm among gay, lesbian, bisexual, and transgender persons in Japan. Participants (N = 84) indicated that suicidality and self-harm are serious problems among sexual minorities and tend to be driven by (a) a homophobic/transphobic environment and the negative consequences of sexual minorities either disclosing their true selves or remaining hidden and silent within such an environment; (b) various antecedents to poor mental health; and (c) factors not directly related to being a sexual minority, particularly unemployment and debt in the context of a protracted national economic decline in Japan prior to the study period of 2003--2004. Participants also perceived a potentially higher risk for suicidality and self-harm among sexual minority adolescents and persons in their early 20s; those who work in the entertainment, bar, or sex industries; and survivors of violence perpetrated by intimate partners or family members.
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Affiliation(s)
- Anthony S DiStefano
- Department of Health Science, California State University, Fullerton, California, USA
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Li Q, Kakizaki M, Kuriyama S, Sone T, Yan H, Nakaya N, Mastuda-Ohmori K, Tsuji I. Green tea consumption and lung cancer risk: the Ohsaki study. Br J Cancer 2008; 99:1179-84. [PMID: 18766189 PMCID: PMC2567088 DOI: 10.1038/sj.bjc.6604645] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We examined the risk of lung cancer in relation to green tea consumption in a population-based cohort study in Japan among 41 440 men and women, aged 40–79 years, who completed a questionnaire in 1994 regarding green tea consumption and other health-related lifestyle factors. During the follow-up period of 7 years (from 1995 to 2001), 302 cases of lung cancer were identified, and the Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The multivariable-adjusted HRs of lung cancer incidence for green tea consumption of 1 or 2, 3 or 4, and 5 or more cups/day as compared to less than 1 cup/day were 1.14 (95% CI: 0.80–1.62), 1.18 (95% CI: 0.83–1.66), and 1.17 (95% CI: 0.85–1.61), respectively (P for trend=0.48). This cohort study has found no evidence that green tea consumption is associated with lung cancer.
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Affiliation(s)
- Q Li
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
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Cardoso BM, Kauer Sant'Anna M, Dias VV, Andreazza AC, Ceresér KM, Kapczinski F. The impact of co-morbid alcohol use disorder in bipolar patients. Alcohol 2008; 42:451-7. [PMID: 18760714 DOI: 10.1016/j.alcohol.2008.05.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 05/26/2008] [Accepted: 05/28/2008] [Indexed: 10/21/2022]
Abstract
Alcohol use is highly prevalent in patients with bipolar disorder (BD) and is associated with significant mortality and morbidity. The detrimental effects of each condition are compounded by the presence of the other. The objective of this study was to examine the impact of alcohol abuse and of alcohol dependence in BD in a Brazilian sample, as indicated by clinical severity, functional impairment, and quality of life (QOL). A cross-sectional survey of 186 bipolar outpatients were interviewed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-4th Edition. The primary outcome measures were functioning, as indicated by the Global Assessment of Functioning Scale scores and QOL, as indicated by the World Health Organization Quality of Life Instrument. Secondary outcomes were clinical severity features. Alcohol abuse and dependence were associated with male gender, lower education, earlier age of onset, psychosis within first episode, depressive symptoms, and worse functioning. In addition, the presence of alcohol abuse or dependence was associated with remarkably high rates of suicide attempt. Our findings suggest that the co-occurrence of alcohol abuse/dependence with BD increases the risk for suicide attempt, which may reflect in part the greater severity of symptoms and impaired functioning. This subgroup of bipolar patients requires a treatment tailored to address both conditions.
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