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Sadek J, Diaz-Piedra B, Saleh L, MacDonald L. A narrative review: suicide and suicidal behaviour in older adults. Front Psychiatry 2024; 15:1395462. [PMID: 38800059 PMCID: PMC11117711 DOI: 10.3389/fpsyt.2024.1395462] [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: 03/04/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Globally, suicide is a public health concern that claims the lives of many each year. The complex etiology and factors contributing to the risk of suicide make it hard to predict the likelihood of death by suicide. Suicide rates have been increasing over the past 25 years in patients aged 65 years and older, and with the expected increases in the size of the older adult population and the under-detection of suicide risk, these rates may continue to increase. To mitigate and attempt to limit this expected increase, it is important to understand the risk and protective factors of suicide in older adults. This narrative review focuses on individuals above the age of 65 and encompasses relevant peer-reviewed publications from the past 25 years to cover fatal and non-fatal suicidal behaviour. It summarizes several important risk factors for suicide and suicidal behaviors while considering how risk can be detected, assessed, prevented, and mitigated. Screening methods to detect suicide and depression in older adults were examined based on their effectiveness and suitability for use in this population. Lastly, the impacts of the COVID-19 pandemic on suicide rates in older adults were described.
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Affiliation(s)
- Joseph Sadek
- Professor, Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - Leah Saleh
- Faculty of Science, Dalhousie University, Halifax, NS, Canada
| | - Luke MacDonald
- MD Candidate, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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2
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Silver D, Bae JY, Macinko J. Protocol for creating a dataset of U.S. state alcohol-related firearm laws 2000-2022. PLoS One 2024; 19:e0299248. [PMID: 38451933 PMCID: PMC10919691 DOI: 10.1371/journal.pone.0299248] [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: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Firearms are a major source of preventable morbidity and mortality in the United States, contributing to over 48,000 deaths in 2022 and generating societal costs in excess of $500 billion. A body of work has examined the relationship between US state level firearm laws and health outcomes, generally finding that some firearm regulations are associated with lower firearm-related mortality. Alcohol has been identified as an additional risk factor for both homicides and suicide and stronger state alcohol laws have been associated with lower rates of suicide. To date, there are no empirical studies that have investigated the impact of laws over a long period of time that target the intersection of alcohol and firearm. One reason for this may be because there is no existing dataset that includes the range of these state laws over time. This study describes the protocol for collecting, coding and operationalizing these legal data.
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Affiliation(s)
- Diana Silver
- New York University School of Global Public Health, New York, NY, United States of America
| | - Jin Yung Bae
- New York University School of Global Public Health, New York, NY, United States of America
| | - James Macinko
- UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States of America
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Fusaroli M, Pelletti G, Giunchi V, Pugliese C, Bartolucci M, Necibi EN, Raschi E, De Ponti F, Pelotti S, Poluzzi E. Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System. Drug Saf 2023; 46:283-295. [PMID: 36689131 PMCID: PMC9869307 DOI: 10.1007/s40264-022-01269-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Deliberate self-poisoning (DSP) using drugs is the preferred method of suicide at a global level. Its investigation is hampered by limited sample sizes and data reliability. We investigate the role of the US FDA Adverse Event Reporting System (FAERS), a consolidated pharmacovigilance database, in outlining DSP habits and toxidromes. METHODS We retrieved cases of 'intentional overdose' and 'poisoning deliberate' from the FAERS (January 2004-December 2021). Using descriptive and disproportionality analyses, we estimated temporal trends, potential risk factors, toxidromes, case-fatality rates and lethal doses (LDs) for the most frequently reported drugs. RESULTS We retrieved 42,103 DSP cases (17% fatal). Most cases were submitted in winter. Reports of DSP involved younger people, psychiatric conditions, and alcohol use, compared with non-DSP, and fatality was higher in men and older patients. Suspected drugs were mainly antidepressants, analgesics, and antipsychotics. Multiple drug intake was recorded in more than 50% of the reports, especially analgesics, psychotropics, and cardiovascular agents. The most frequently reported drugs were paracetamol, promethazine, amlodipine, quetiapine, and metformin. We estimated LD25 for paracetamol (150 g). CONCLUSION Worldwide coverage of the FAERS complements existing knowledge about DSP and may drive tailored prevention measures to timely address the DSP phenomenon and prevent intentional suicides.
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Affiliation(s)
- Michele Fusaroli
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Guido Pelletti
- Legal Medicine Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Valentina Giunchi
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Chiara Pugliese
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mattia Bartolucci
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - Elena Narmine Necibi
- School of Emergency Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Emanuel Raschi
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Fabrizio De Ponti
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Susi Pelotti
- Legal Medicine Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elisabetta Poluzzi
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Lange S, Jiang H, Kaplan MS, Kim KV, Rehm J. Association Between Acute Alcohol Use and Firearm-Involved Suicide in the United States. JAMA Netw Open 2023; 6:e235248. [PMID: 36988957 PMCID: PMC10061235 DOI: 10.1001/jamanetworkopen.2023.5248] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Importance Firearms are the method of suicide used most often in the US. Acute alcohol use is associated with an increased risk of suicide by firearm. However, the dose-response association between acute alcohol use and the probability of using a firearm as the method of suicide is unknown. Objective To evaluate the association between the amount of alcohol consumed and the probability of using a firearm as the method of suicide. Design, Setting, and Participants This cross-sectional study used mortality data from the US National Violent Death Reporting System on suicide decedents aged 18 years or older with a positive blood alcohol concentration (BAC; ie, ≥0.01 g/dL). Statistical analysis was performed from January 2003 to December 2020. Exposure Acute alcohol use, ascertained via postmortem toxicologic examination. Main Outcomes and Measures Probability of using a firearm as the method of suicide compared with all other methods of suicide. Results The study included 45 959 male suicide decedents (mean [SD] age, 42.6 [14.8] years) and 12 136 female suicide decedents (mean [SD] age, 44.2 [13.8] years) with a positive BAC; of those, 24 720 male decedents (53.8%) and 3599 female decedents (29.7%) used a firearm as the method of suicide. The probability of using a firearm as the method of suicide when alcohol is consumed was higher for male decedents, with the probability starting at just below 0.50 and increasing to approximately 0.75. In contrast, for female decedents, the probability began at just above 0.30 and increased to approximately 0.55. For both male and female decedents, the dose-response curves were an inverted U shape; as BAC increased, the probability of firearm-involved suicide initially increased and then decreased at very high BACs (approximately 0.40 g/dL for male decedents and approximately 0.30 g/dL for female decedents; these BACs were present among only a small percentage of alcohol-involved suicides: male decedents, 589 [1.3%]; female decedents, 754 [6.2%]). Conclusions and Relevance This cross-sectional study of suicide decedents who had consumed alcohol prior to their death suggests that, as alcohol consumption increased, the probability of a firearm-involved suicide increased until a certain BAC, at which point the probability started to decrease.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Thaysa Bier de Sousa N, Vedana KGG, Zanetti ACG, de Souza J, da Silva AHS, Miasso AI. Intentional self-poisoning with medications: Occurrence, recurrence and suicide deaths. DEATH STUDIES 2023:1-9. [PMID: 36794403 DOI: 10.1080/07481187.2023.2175390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This study aimed to identify the sociodemographic and clinical factors associated with the occurrence and recurrence of intentional self-poisoning with medications (ISP-M), and suicide deaths by ISP-M in the state of Mato Grosso, Brazil. In this cross-sectional analytical study, we used logistic regression models to analyze data obtained through health information systems. Factors associated with use of ISP-M as a method were female gender, white skin color, occurrence in urban areas and at home. The ISP-M as a method was less reported in people presumed under the influence of alcohol. Lower chance of death by suicide using ISP-M was found among young people and adults (under 60 years old).
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Affiliation(s)
- Nágella Thaysa Bier de Sousa
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Kelly Graziani Giacchero Vedana
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Ana Carolina Guidorizzi Zanetti
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Jacqueline de Souza
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Amanda Heloisa Santana da Silva
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Adriana Inocenti Miasso
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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Acute use of alcohol before suicide in Kazakhstan: A population-wide study. J Affect Disord 2023; 321:134-139. [PMID: 36272459 DOI: 10.1016/j.jad.2022.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Acute use of alcohol is a proximal risk factor for suicidal behavior and suicide attempts. Previous studies have established that alcohol consumption prior to suicide increases the risk of suicide completion. Thus, the current study aims to explore the association between alcohol use and suicide mortality in Kazakhstan. This is the first study to address this association in Kazakhstan. METHODS The main outcome measure was the presence of alcohol in blood of suicide decedents. Logistic regression models were used to test unadjusted and adjusted odds ratios of the risk of suicide involving acute use of alcohol. Regression modeling was used to identify significant predictors of alcohol use among suicide decedents. RESULTS Males (22.5 %) used alcohol more commonly before conducting suicide than females (13.4 %). The odds of alcohol involvement was 2.73 times higher for males compared to females after controlling for age and other covariates. Being a male younger than 45 years old and using suicide methods such as poisoning, immolation, and drowning increased the odds of acute use of alcohol among suicide decedents. LIMITATIONS Data on alcohol use included information only on individuals with a positive alcohol test, and it is unknown how many suicide decedents were not tested for alcohol. CONCLUSIONS Alcohol use is common factor contributing to suicide, particularly among young and middle-aged male adults. Alcohol use is also associated more strongly with certain methods of suicide. Further studies and more detailed data exploring alcohol consumption and suicide risks are needed in countries such as Kazakhstan.
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Buleyko AA, Soldatkin VA. [Impact of alcohol abuse on suicide risk in schizophrenic patients]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:144-148. [PMID: 34874670 DOI: 10.17116/jnevro2021121101144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Suicide is one of the main causes of death among patients with mental illnesses. At the same time, alcohol consumption is associated with high risk of autoaggressive and suicidal behavior in population. On the other hand there is an opinion that alcohol may have an illusory-compensatory effect. In that case, alcohol consumption may be an attempt to decrease different symptoms such as depression, anxiety or hallucinations. An analysis of co-occurring schizophrenia and alcohol abuse is presented. Suicide statistics among patients with schizophrenia is studied. Different mechanisms contributing to suicide are highlighted. The correlations of other risk factors with suicide attempts with the assessment of the patient's social resources and environment were studied. The role of alcohol in the presence of other obvious risk factors has been assessed. Possible mechanisms of the protective role of alcohol in relation to suicides among patients with schizophrenia are presented. The authors outline topics of perspective research to clarify the risk of self-destructive behavior in patients with schizophrenia with comorbid alcohol dependence, to search for its predictors and to develop well-grounded complex preventive measures.
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Affiliation(s)
- A A Buleyko
- Rostov State Medical University, Rostov, Russia
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Pan CH, Chen PH, Chang HM, Wang IS, Chen YL, Su SS, Tsai SY, Chen CC, Kuo CJ. Incidence and method of suicide mortality in patients with schizophrenia: a Nationwide Cohort Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1437-1446. [PMID: 33245380 DOI: 10.1007/s00127-020-01985-8] [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: 07/16/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Suicide is a leading cause of death in patients with schizophrenia. This nationwide cohort study investigated the incidence of each suicide method in patients with schizophrenia compared with the general population. METHODS In total, records of 174,039 patients with schizophrenia were obtained from the National Health Insurance Research Database in Taiwan from 2001 to 2016. This schizophrenia cohort was linked with the national mortality database, and 26,926 patients died during this follow-up period. Of the deceased, 3033 had died by suicide. Univariate Cox regression was used to estimate the demographic variables associated with suicide. We estimated the difference in the proportion of each suicide method used in patients with schizophrenia compared with the general population. The incidence and standardized mortality ratio (SMR) of each suicide method were calculated and stratified based on sex. RESULTS Patients aged 25-34 years exhibited the highest suicide risk. Compared with the general population, patients with schizophrenia were more likely to commit suicide by jumping and drowning and less likely to use charcoal-burning and hanging. Women showed a higher incidence of suicide by drowning and jumping than did men. Comorbidity with substance use disorders (SUDs) was associated with a high suicide SMR (26.9, 95% confidence interval [CI] = 23.4-28.9), particularly for suicide by jumping (61.2, 95% CI = 48.3-76.3). CONCLUSIONS Patients with schizophrenia had higher suicide rates for all methods than did the general population. Suicide method differed based on sex. Patients with SUDs exhibit a high SMR for each suicide method and warrant intensive clinical attention.
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Affiliation(s)
- Chun-Hung Pan
- Department of Psychology, National Chengchi University, Taipei, Taiwan.,Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Pao-Huan Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - I-Shuan Wang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yi-Lung Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Counseling Psychology, Chinese Culture University, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan. .,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan. .,Department of General Psychiatry, Taipei City Psychiatric Center, 309 Sung-Te Road, Taipei, 110, Taiwan.
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Li J, Bornheimer LA, Fernandez L, Dagher J. The Relationships Between Risk-Taking, Depression, and Alcohol Use in the Experience of Suicidal Ideation Among Adults in the General Population. CRISIS 2021; 43:228-235. [PMID: 33890825 DOI: 10.1027/0227-5910/a000775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Risk-taking is associated with suicide among depressed adolescents. In the United States, alcohol is among the most used substances resulting in need for treatment. While alcohol use relates to greater depression and suicidality, less is known about these relationships with risk-taking tendencies, particularly among adult populations. The current study examined suicidal ideation, alcohol use, depression, and risk-taking tendencies among adults 18-65 years old who participated in the 2017 National Survey on Drug Use and Health. Structural equation modeling was used to examine the specific aims in Mplus8. A total of 1,740 (21.4%) participants endorsed suicidal ideation. The model demonstrated good fit and findings indicate increases in alcohol abuse or dependence (b = 0.094, SE = 0.01, p < .001), depression (b = 0.036, SE = 0.01, p < .001), and risk-taking (b = 0.044, SE = 0.01, p < .001) all independently related to increased odds of ideation. Increases in alcohol abuse or dependence (b = 0.210, SE = 0.02, p < .001) and depression (b = 0.026, SE = 0.01, p < .05) also related to elevated risk-taking. Based on the joint significance test, risk-taking tendencies served as a partial mediator, functioning as a mechanism in the relationships between alcohol use, depression, and ideation. Risk-taking thus serves as an important treatment target in the prevention of suicide. Implications for practice and future research are discussed.
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Affiliation(s)
- Juliann Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Lindsay A Bornheimer
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Jenna Dagher
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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10
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Anjos TGD, Carvalho DSBD, Machado AC, Carvalho MDSLD, Lyrio AO, Souza ES, Gomes JDA, Hintz AM, Cruz SSD, Gomes-Filho IS, Figueiredo ACMG, Pereira MG. Associated factors to abusive alcoholic beverage consumption in suicide victims. Drug Alcohol Depend 2021; 221:108613. [PMID: 33662671 DOI: 10.1016/j.drugalcdep.2021.108613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Suicide is a worldwide phenomenon, as well as a challenge for public health, and alcoholic beverage abuse is one of the most important risk factors. However, the association between possible factors related to alcoholic beverage consumption in suicide victims has rarely been investigated. OBJECTIVE To evaluate the factors associated with abusive alcoholic beverage consumption among people who died from suicide in the Brazilian Federal District (BFD). METHOD A population-based and cross-sectional study with suicide victims in the BFD between 2016 and 2017. Information was collected about sociodemographic characteristics, autopsy appraisal, and drug use. A trained team evaluated all cases to define factors associated with abusive alcoholic beverage consumption. This outcome was measured using the Blood Alcohol Concentration. Poisson regression analysis was applied to calculate the Prevalence Ratios and respective populational confidence intervals. RESULTS The findings of the present study were collected from a database containing information related to 278 suicide victims. Being male and having cocaine identified in the toxicological test were the factors that showed a strong association with abusive alcohol beverage consumption in suicide victims. Other factors showed a slight association (PR < 1.5): having an education level with greater than 8 years of study, being black, having a professional occupation or being retired or pensioner, and having the presence of cannabis in the toxicological test. CONCLUSION Socioeconomic-demographic and behavioral factors proved to be positively associated with abusive alcoholic beverage consumption among suicide victims, suggesting the need for effective public health policy measures to combat this health problem.
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Affiliation(s)
| | | | | | | | | | - Elivan Silva Souza
- Department of Health of Univesity of Brasilia, Federal District, Brazil.
| | | | | | - Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo of Bahia, Bahia, Brazil.
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11
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Zhu RT, Ma ZY, Jia CX, Zhou L. Completed Suicide With Violent and Non-violent Methods by the Elderly in Rural China: A Psychological Autopsy Study. Front Psychiatry 2021; 12:624398. [PMID: 34211408 PMCID: PMC8239144 DOI: 10.3389/fpsyt.2021.624398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Late-life suicide is a severe public health problem in rural China; however, knowledge regarding the specific characteristics and risk factors for completed suicide via violent and non-violent methods among elderly individuals in rural China is limited. Methods: Subjects aged 60 years or older were selected from rural areas in Shandong, Hunan, and Guangxi provinces in China. This study was a 1:1 matched case-control design conducted by using the psychological autopsy method. Results: According to the univariate analyses, the presence of mental disorder, higher degree of depression, loneliness, lack of social support, hopelessness, impulsivity, and increased quantity of life events were associated with suicide in both violent and non-violent methods. For violent suicide, another risk factor was the lack of pesticides at home. For non-violent suicide, other risk factors were not currently married, family suicide history, and alcohol use disorder (P < 0.05). Variables that remained in the logistic regression model were the severity of depressive symptoms for both violent and non-violent suicide. For non-violent suicide, the degree of hopelessness was another independent risk factor. In addition, violent suicides were more likely to lack pesticides at home, choose the spring season and have an increased quantity of life events than those who died by suicide via non-violent methods. Conclusion: The major risk factor for both violent and non-violent suicide was the severity of depressive symptoms. Suicide prevention measures that focus on depression among this vulnerable population are urgently needed. Moreover, the characteristics of suicides via violent methods differed from those via non-violent methods among elderly individuals. Suicide prevention efforts should be tailored to the specific characteristics of the different suicide methods utilized by older adults in rural areas.
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Affiliation(s)
- Rong-Ting Zhu
- Guangzhou Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhen-Yu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Liang Zhou
- Guangzhou Brain Hospital, Guangzhou Medical University, Guangzhou, China
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12
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Chong DG, Buckley NA, Schumann JL, Chitty KM. Acute alcohol use in Australian coronial suicide cases, 2010-2015. Drug Alcohol Depend 2020; 212:108066. [PMID: 32473536 DOI: 10.1016/j.drugalcdep.2020.108066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute use of alcohol is a robust risk factor for suicide, reported in approximately one- to two-fifths of suicide cases. Comparisons of risk factors between suicides with and without prior acute alcohol consumption have not been investigated in Australia. This study addresses the gap by examining individual factors (age, sex, employment status, method of suicide) and environmental factors (month of death, jurisdiction) between alcohol and non-alcohol suicide. METHODS Data for all suicide deaths (aged 15 and over) in Australia were obtained from the National Coronial Information System (NCIS). Blood alcohol concentrations (BAC) were extracted from coronial reports, along with demographic information. Alcohol consumption prior to suicide was assumed if BAC ≥ 0.05 g/100 mL. We compared case characteristics between alcohol related and non-alcohol related suicides using logistic regression. RESULTS 26.7% of suicide deaths in Australia had a BAC ≥ 0.05 g/100 mL. Alcohol use prior to suicide was associated with male gender (adjusted odds ratio [AOR]: 1.14, 95% confidence interval [95%CI]: 1.03, 1.26), being aged between 35-44 years (AOR: 1.26, 95%CI: 1.08, 1.46) and hangings (AOR: 1.53, 95%CI: 1.08, 1.46). Mean suicides per month over the timeframe demonstrated significant seasonality. Mean counts per month for alcohol related suicides peaked in December, compared to a peak in September for non-alcohol related suicides. CONCLUSIONS This study highlights differences between alcohol related and non-alcohol related suicides including sex, age, method of death, time of year and location within Australia. Targeting alcohol related suicide should be a key priority in comprehensive suicide prevention strategies.
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Affiliation(s)
- D G Chong
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia
| | - N A Buckley
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia
| | - J L Schumann
- Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
| | - K M Chitty
- The University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Building K06, Level 3, Room 307A, 1 - 3 Ross St, Sydney, NSW, 2006, Australia.
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Radnic B, Bogdanovic M, Durmic T, Popovic V, Mihailovic Z, Soldatovic I, Atanasijevic T. Can blood alcohol concentration have a role in choosing high lethality method of suicide? AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1757759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bojana Radnic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milenko Bogdanovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tijana Durmic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Popovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Mihailovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute for Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Atanasijevic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
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Perez J, Beale E, Overholser J, Athey A, Stockmeier C. Depression and alcohol use disorders as precursors to death by suicide. DEATH STUDIES 2020; 46:619-627. [PMID: 32238058 DOI: 10.1080/07481187.2020.1745954] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The combined presence of depression with alcohol abuse can increase suicide risk. We used psychological autopsy to evaluate 101 individuals who died by suicide, to understand relationships between stressful life events, alcohol abuse, and depression. As compared to suicidal adults with depression only, individuals meeting criteria for both a depressive disorder and alcohol use disorder tended to be younger and experienced higher rates of stressful life events during the six months prior to death. Alcohol abuse likely influences interpersonal conflict, financial distress, and legal problems. Interventions focusing on managing life problems may help to reduce suicide risk.
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Affiliation(s)
- Jalessa Perez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Eleanor Beale
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - James Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alison Athey
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Craig Stockmeier
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Psychiatry and Human Behavior, Division of Neurobiology and Behavior Research, Translational Research Center (TR415), University of Mississippi Medical Center, Cleveland, Ohio, USA
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Hesse M, Thylstrup B, Seid AK, Skogen JC. Suicide among people treated for drug use disorders: a Danish national record-linkage study. BMC Public Health 2020; 20:146. [PMID: 32005222 PMCID: PMC6995113 DOI: 10.1186/s12889-020-8261-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000–2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide. Results There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age- and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50). Conclusions Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
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Affiliation(s)
- Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.
| | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Abdu Kedir Seid
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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16
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Gauthier JM, Cole AB, Bagge CL. A preliminary examination of the association between drinking as a typical coping strategy and level of acute alcohol consumption prior to a suicide attempt. Psychiatry Res 2019; 282:112626. [PMID: 31685287 PMCID: PMC6923992 DOI: 10.1016/j.psychres.2019.112626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 01/02/2023]
Abstract
Drinking to cope is associated with suicide ideation and attempts. Event-based research shows drinking, particularly when alcohol is consumed in large quantities, increases the intensity of suicidal thoughts and immediate risk for attempt. Such findings suggest those who typically drink to cope may be especially likely to drink heavily in the hours preceding a suicide attempt. In the first examination of the association between regular use of alcohol as a coping strategy and acute alcohol consumption prior to a suicide attempt, participants included 130 patients hospitalized for a recent attempt. The number of drinks consumed in the acute period preceding the attempt, as well as past-year heavy drinking frequency, typical drinking motives, and depressive symptoms were assessed. The unique impacts of coping motives on odds of consuming any alcohol, and of using specific amounts of alcohol in the acute period, were determined through binary and multinomial logistic regressions. Results demonstrated that commonly drinking for coping motives increased the odds of heavy drinking - but not of using alcohol at low levels - during the acute period. Results held after adjusting for relevant covariates. Clinicians should assess drinking motives and prioritize prevention of drinking to cope to reduce risk of alcohol-related suicide attempts.
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Affiliation(s)
- Jami M Gauthier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Substance Abuse Treatment Program, Atlanta VA Medical Center, Atlanta, GA, United States.
| | - Ashley B Cole
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, United States; Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, MI, United States
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17
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Aghazadeh-Attari J, EntezarMahdi R, Ahmadzadeh J, Mobaraki K, Mansorian B, Karimi H, Mirghaffarzadeh S, Hajimohammadian M, Mohebbi I. The Burden of Premature Mortality Related to Suicide in West Azerbaijan From 2014 to 2016. CRISIS 2019; 40:407-412. [PMID: 30888228 DOI: 10.1027/0227-5910/a000581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Examining the premature death rate represents the first step in estimating the overall burden of disease, reflecting a full picture of how different causes affect population health and providing a way of monitoring and evaluating population health. Aims: This study was conducted to assess the burden of premature mortality from suicides in West Azerbaijan Province, northwest of Iran from 2014 to 2016. Method: To calculate years of potential life lost (YPLL), we categorized all methods of suicide, then we subtracted actual age at death by suicide from the relevant age-based life table produced by the World Health Organization in 2015, after which we added the results for each type of suicide in a particular year. Results: We analyzed 638 suicides. Overall, during the 3-year study period for both sexes, the greatest sources of premature death among all methods of suicide were: hanging, strangulation, and suffocation (X70); smoke, fire, and flames (X76); and poisoning by narcotics and psychodysleptics (X62). Limitations: Limitations of the study include a lack of accurate, systematic recording and reporting of all cases of suicide, which might lead to measurement bias. Conclusion: This study identified and highlighted the most common methods of suicide in West Azerbaijan.
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Affiliation(s)
- Javad Aghazadeh-Attari
- Department of Neurosurgery, Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasool EntezarMahdi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Jamal Ahmadzadeh
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazhal Mobaraki
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Behnam Mansorian
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Hasan Karimi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Shamsi Mirghaffarzadeh
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahnaz Hajimohammadian
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Predicting Planned Suicide Attempts With the Columbia-Suicide Severity Rating Scale: A Subanalysis of the 2013 Korea National Suicide Survey on Emergency Department Visitors. J Nerv Ment Dis 2019; 207:59-68. [PMID: 30672875 DOI: 10.1097/nmd.0000000000000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Identifying predictors of planned suicide attempts (PSA) is critical because these are associated with grave consequences. Using data of suicide attempters visiting emergency departments, we investigated whether the Columbia-Suicide Severity Rating Scale (C-SSRS) subscales, by retrospectively evaluating ideation before an attempt, could predict the occurrence of PSA versus unplanned suicide attempts using logistic regression analyses. The severity subscale was used as a continuous (model A) and a categorical (model B) variable. In model A, higher scores on each subscale were associated with increased risk of PSA. In model B, the highest score on the severity subscale and a higher intensity subscale score predicted PSA. The severity and intensity subscales had areas under receiver operating curves of 0.712 and 0.688 with optimum cutoff points of 4/5 and 15/16, respectively. In addition, being aged 30 to 49 and 50 to 69 years, being male, interpersonal stress, and depressive and adjustment disorders increased PSA risk. The C-SSRS subscales, along with sociodemographic and clinical risk factors, can predict PSA.
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19
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Pillon SC, Vedana KGG, Teixeira JA, Dos Santos LA, de Souza RM, Diehl A, Rassool GH, Miasso AI. Depressive symptoms and factors associated with depression and suicidal behavior in substances user in treatment: Focus on suicidal behavior and psychological problems. Arch Psychiatr Nurs 2019; 33:70-76. [PMID: 30663628 DOI: 10.1016/j.apnu.2018.11.005] [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: 06/10/2018] [Revised: 10/23/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
AIM To investigate the prevalence of depressive symptoms, psychological problems, suicidal behaviour and their associations in substance users in treatment. METHODS A cross-sectional study, with 307 substance users in an out-patient treatment facility, was undertaken. Socio-demographic data, psychoactive substances used, depressive symptoms, and suicide information were obtained. RESULTS 70% of participants were depressed; of those, 8.1% were either under the influence of drugs or in withdrawal. Suicidal ideation was found to be present in those who had anxiety, were nervous, had depressive symptoms, or were under drug influence or in withdrawal. CONCLUSION It is important to identify potential suicidal risk factors and implement the management of these conditions in substance users.
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Affiliation(s)
- Sandra Cristina Pillon
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
| | - Kelly Graziani Giacchero Vedana
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
| | - Jessica Adrielle Teixeira
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil
| | | | - Roberto Molina de Souza
- Federal Technological University of Paraná, Brazil; Academic Department of Mathematics (DAMAT), Cornélio Procópio, Paraná, Brazil
| | - Alessandra Diehl
- Federal University of São Paulo (UNIFESP), Psychiatric Department, Brazil
| | | | - Adriana Inocenti Miasso
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
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Park CHK, Lee JW, Lee SY, Shim SH, Kim SG, Lee J, Kim MH, Paik JW, Cho SJ, Moon JJ, Jeon DW, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Characteristics of the "young-old" and "old-old" community-dwelling suicidal Ideators: A longitudinal 6-month follow-up study. Compr Psychiatry 2019; 89:67-77. [PMID: 30597426 DOI: 10.1016/j.comppsych.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/20/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Despite heterogeneity of older people in suicidal behavior, research identifying characteristics by age groups is scarce. We examined baseline features of older community-dwelling suicidal ideators by dichotomized age groups and the 6-month trajectory of their suicidal ideation along with its related psychopathology. Predictors of suicidal ideation within each group were investigated. METHODS Older community-dwelling suicidal ideators enrolled in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were subdivided into the "young-old (65-74 years)" and "old-old (≥75 years)" group. Baseline, 1-, and 6-month assessments were compared. Within each group, multiple regression analysis using rating scales (Patient Health Questionnaire-9, Beck Anxiety Inventory, Alcohol Use Disorders Identification Test, Stress Questionnaire for Korean National Health and Nutrition Examination Survey-Short Form, and Social Relationships Scale) was conducted to identify predictors of suicidal ideation measured with the intensity subscale of the Columbia-Suicide Severity Rating Scale. Two-way repeated-measures analysis of variance (RM-ANOVA) was used to compare changes in suicidal ideation, depression, anxiety between age groups over time, and one-way RM-ANOVA to examine changes within each age group. RESULTS Among 29 "young-old" and 53 "old-old" ideators, the latter were less likely to be receiving psychiatric treatment (odds ratio [OR] = 4.065) and make suicide attempts (OR = 2.874), whereas the former revealed greater levels of anxiety and stress. Baseline depression and stress in the "young-old" group and the "old-old" group, respectively, predicted the intensity of suicidal ideation at both baseline and 1-month assessments. No significant age group x time interactions on suicidal ideation and depression were found. However, within each age group, both suicidal ideation and depression significantly decreased only during the first month with no further improvement. CONCLUSION We speculate cautiously that more attention may need to be paid to the "old-old" ideators in the evaluation of psychiatric issues and for referral to psychiatrists. To decrease suicidal ideation, tailored approaches involving proactive, timely management of depression in the "young-old" and interventions focusing on stress reduction in the "old-old," would be helpful.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwang-ro, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do 26426, Republic of Korea.
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdae-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea.
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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21
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Park CHK, Lee JW, Lee SY, Moon JJ, Jeon DW, Shim SH, Cho SJ, Kim SG, Lee J, Paik JW, Kim MH, Kim S, Park JH, You S, Jeon HJ, Rhee SJ, Ahn YM. The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study. Compr Psychiatry 2019; 88:29-38. [PMID: 30468986 DOI: 10.1016/j.comppsych.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants. METHODS Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality. RESULTS A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment. CONCLUSIONS Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwangno, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdea-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea.
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Suicide Methods According to Age and Sex: An Analysis of Data of 239,565 Suicide Victims in the Republic of Korea From 1991 to 2015. J Nerv Ment Dis 2018; 206:770-775. [PMID: 30273273 DOI: 10.1097/nmd.0000000000000889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Because suicide is irreversible, prevention is paramount. For the optimal strategy to reduce lethal means, we sought to investigate age- and sex-associated variations in suicide methods. Data on annual causes of death from 1991 to 2015 in the Republic of Korea were used. Major sociodemographic correlates of the five suicide methods were analyzed by multiple multinominal logistic regression analysis. Among a total of 239,565 suicides from 1991 to 2015, hanging was most common. Gas poisoning sharply increased from 2007 to 2015. The gap between hanging and the second most common method of suicide has increased from 659 in 2004 to 4,433 in 2015. Charcoal burning was most commonly used by males younger than 45 years of age, whereas pesticide was commonly used by both sexes ages 55 years and older. Our results suggest that age- and sex-specific suicide prevention strategies are needed, particularly for gas and pesticide poisoning.
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Deisenhammer EA, Stiglbauer C, Kemmler G. [Time-related aspects of suicides - suicide frequency related to birthday, major holidays, day of the week, season, month of birth and zodiac signs]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2018; 32:93-100. [PMID: 29516359 DOI: 10.1007/s40211-018-0260-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/08/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Suicides are generally the consequence of overchallenged coping strategies of individual for psychological, social or internal and external biological strain factors. Timing of the suicide, too, may be influenced by external factors. Studies so far have yielded in part inconsistent results concerning the association of suicides with particular days or periods of the year. Even less is known regarding a potential effect of the time of birth on suicide risk. METHODS The Tyrol Suicide Register (TSR) provides data on suicides occurring in the Austrian State of Tyrol including birthday of the suicide victim and day of the suicide. In the present study the frequency of suicides was analyzed with regard to birthday, day of the week, major holidays and season over a period of 17 years. Further, a potential association with month of birth and zodiac signs was studied. RESULTS We found a significant variation in suicide frequency concerning day of the week with a peak on Mondays and Tuesdays and seasonality with increased numbers in spring and summer months. CONCLUSIONS The increase of suicide numbers at the beginning of the week may be explained by the "broken-promise effect" which has been described as the consequence of frustrated expectations concerning the weekend. Possible explanations for the suicide peaks in spring and summer may be biological, specifically serotonergic alterations as well as the experience of depressed patients perceiving the social and emotional contrast to people who are able to enjoy these periods of pleasure and outdoor activities.
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Affiliation(s)
- Eberhard A Deisenhammer
- Universitätsklinik für Psychiatrie 1, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
- Universitätsklinik für Psychiatrie 2, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - Christoph Stiglbauer
- Universitätsklinik für Psychiatrie 1, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - Georg Kemmler
- Universitätsklinik für Psychiatrie 1, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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Pridmore S, Money TT, Pridmore W. Suicide: What the General Public and the Individual Should Know. Malays J Med Sci 2018; 25:15-19. [PMID: 30918451 PMCID: PMC6422589 DOI: 10.21315/mjms2018.25.2.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/08/2017] [Indexed: 11/30/2022] Open
Abstract
Background The predominant, current western view is that all suicide is the result of mental disorder. This view is much too narrow and does not admit extensive information regarding the social, economic, and forensic factors (among many others) which may contribute to completed suicide. A consequence of this narrow view is that prevention strategies mainly focus on the detection and treatment of mental disorder. A preferred approach is to place greater emphasis on public health approaches to suicide prevention. Objective To develop and suggest a body of information which may be useful in a public health approach to suicide. Conclusion It is suggested that the following be available to the general public: i) suicide is a fact of life which should be minimised, ii) suicide has many different triggers, iii) most people who take their lives are able to make decisions, and iv) increased public discussion and understanding of suicide is desirable. Five pieces of information that may be useful to those contemplating suicide include: i) don’t murder the part of you that wants to live, ii) suicide actions may leave you alive but disabled, iii) suicide hurts other people, iv) suicidal impulses do pass if you hold on, and v) suicide is a waste.
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Affiliation(s)
- Saxby Pridmore
- Discipline of Psychiatry, University of Tasmania, Hobart, TAS, Australia
| | - Tammie T Money
- Post-Graduate Student, Australian National University Medical School, Garran, ACT, Australia
| | - William Pridmore
- Post-Graduate Student, Australian National University Medical School, Garran, ACT, Australia
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Factors Affecting Suicide Method Lethality Among Suicide Attempters in the Korea National Suicide Survey. J Nerv Ment Dis 2018; 206:202-210. [PMID: 28902068 DOI: 10.1097/nmd.0000000000000735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is the first national survey study in South Korea investigating the relationship between suicide lethality and the clinical information of suicide attempters. An interview questionnaire was used to assess their sociodemographic factors, medical and psychiatric information, and two suicide scales, the Columbia-Suicide Severity Rating Scale and the Suicide Intent Scale. Suicide methods were categorized as low and high lethality; low lethality covered drug overdose or self-cutting behavior, and high lethality covered all other methods. High and low lethality suicide method groups were significantly different in demographic, medical, and psychiatric factors. The two scale score distributions differed significantly across two groups, and the difference was also valid for the subcategory analyses of the Suicide Intent Scale. Multiple factors such as older age, male sex, no previous psychiatric history, and previous suicide attempt, as well as high suicide intent by means of suicide scale, affect selection of suicide method of high lethality.
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Characteristics of completed suicide in different blood alcohol concentrations in Korea. Forensic Sci Int 2017; 281:37-43. [DOI: 10.1016/j.forsciint.2017.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/08/2017] [Accepted: 10/11/2017] [Indexed: 11/19/2022]
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Park CHK, Lee JW, Lee SY, Moon J, Shim SH, Paik JW, Kim SG, Cho SJ, Kim MH, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Comparison of Baseline Characteristics between Community-based and Hospital-based Suicidal Ideators and Its Implications for Tailoring Strategies for Suicide Prevention: Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior. J Korean Med Sci 2017; 32:1522-1533. [PMID: 28776350 PMCID: PMC5546974 DOI: 10.3346/jkms.2017.32.9.1522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/17/2017] [Indexed: 11/20/2022] Open
Abstract
In this cross-sectional study, we aimed to identify distinguishing factors between populations with suicidal ideation recruited from hospitals and communities to make an efficient allocation of limited anti-suicidal resources according to group differences. We analyzed the baseline data from 120 individuals in a community-based cohort (CC) and 137 individuals in a hospital-based cohort (HC) with suicidal ideation obtained from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study. First, their sociodemographic factors, histories of medical and psychiatric illnesses, and suicidal behaviors were compared. Second, diagnosis by the Korean version of the Mini International Neuropsychiatric Interview, scores of psychometric scales were used to assess differences in clinical severity between the groups. The results revealed that the HC had more severe clinical features: more psychiatric diagnosis including current and recurrent major depressive episodes (odds ratio [OR], 4.054; P < 0.001 and OR, 11.432; P < 0.001, respectively), current suicide risk (OR, 4.817; P < 0.001), past manic episodes (OR, 9.500; P < 0.001), past hypomanic episodes (OR, 4.108; P = 0.008), current alcohol abuse (OR, 3.566; P = 0.020), and current mood disorder with psychotic features (OR, 20.342; P < 0.001) besides significantly higher scores in depression, anxiety, alcohol problems, impulsivity, and stress. By comparison, old age, single households, and low socioeconomic status were significantly associated with the CC. These findings indicate the necessity of more clinically oriented support for hospital visitors and more socioeconomic aid for community-dwellers with suicidality.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea
| | - Jungjoon Moon
- Department of Psychiatry, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Se Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea
| | - Jong Woo Paik
- Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Seong Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seokho Kim
- Deparmtent of Sociology, Seoul National University College of Social Sciences, Seoul, Korea
| | - Jae Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, Suwon, Korea
| | - Sungeun You
- Department of Psychology, Chungbuk National University College of Social Sciences, Cheongju, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.
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