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Oh H, Jacob L, Soffer-Dudek N, Shin JI, Smith L, Besecker M, Leaune E, Pickering TA. The synergy of depression and flourishing/languishing on suicidal thoughts and behaviors: Findings from a national sample of emerging adult students in higher education in the United States. PLoS One 2024; 19:e0309020. [PMID: 39190722 DOI: 10.1371/journal.pone.0309020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 08/03/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Suicide is a leading cause of death among students in higher education, driven in large part by mental illness, but also mental wellness. Relatively few studies have examined the extent to which depression and flourishing/languishing interact in relation to suicidal thoughts and behaviors. METHODS We analyzed data from the Healthy Minds Study (2020-2021; emerging adult students aged 18-29; N = 101,435), and calculated interaction contrast ratios to estimate the interaction between depression and flourishing/languishing on suicidal thoughts and behaviors, using an additive scale, adjusting for age, gender, race/ethnicity, and food insecurity. RESULTS When compared with students who were flourishing without depression, the students who were languishing without depression, and the students who were depressed but still flourishing had significantly greater odds of suicidal thoughts and behaviors. However, students who were depressed and languishing had the greatest odds, exceeding the sum of the individual effects. CONCLUSION The interaction of depression and flourishing/languishing produced a synergy that increased odds of suicidal thoughts and behaviors. Flourishing interventions may prove to be an effective strategy for universal suicide prevention.
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Affiliation(s)
- Hans Oh
- University of Southern California, Los Angeles, CA, United States of America
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Sant Boi de Llobregat, Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, AP-HP, Lariboisière-Fernand Widal Hospital, Université Paris Cité, Paris, France
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité, Paris, France
| | - Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Megan Besecker
- University of Southern California, Los Angeles, CA, United States of America
| | - Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France
- RESearch on HealthcAre PErformance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Trevor A Pickering
- University of Southern California, Los Angeles, CA, United States of America
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Rasmus S, Wexler L, White L, Allen J. Examining community-level protection from Alaska Native suicide: An Indigenous knowledge-informed extension of the legacy of Michael Chandler and Christopher Lalonde. Transcult Psychiatry 2024:13634615241255713. [PMID: 39169864 DOI: 10.1177/13634615241255713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Chandler and Lalonde broadened the scope of inquiry in suicide research by providing theoretical grounding and empirical support for the role of community, culture, and history in understanding Indigenous youth suicide and reimagining its prevention. Their work pushed the field to consider the intersectional process of individual and collective meaning-making in prevention of Indigenous suicide, together with the central role culture plays in bringing coherence to this process over time. Their innovation shifted the research focus to include the shared histories, contexts, and structures of meaning that shape individual lives and behaviors. We describe here a new generation of research extending their pathbreaking line of inquiry. Recent work aims to identify complex associations between community-level structures and suicidal behavior by collaborating with Alaska Native people from rural communities to describe how community protective factors function as preventative resources in their daily lives. Community engagement and knowledge co-production created a measure of community protection from suicide. Structured interviews with rural Alaska Native community members allowed use of this measure to produce relevant, accessible, and actionable knowledge. Ongoing investigations next seek to describe their mechanisms in shaping young people's lives through a multilevel, mixed-methods community-based study linking community-level protection to protection and well-being of individual youth. These efforts to understand the multiple culture-specific and culturally mediated pathways by which communities build on their strengths, resources, and practices to support Indigenous young people's development and reduce suicide risk are inspired by and expand on Chandler and Lalonde's remarkable legacy.
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Affiliation(s)
- Stacy Rasmus
- University of Alaska Fairbanks, Fairbanks, AK, USA
| | | | | | - James Allen
- University of Alaska Fairbanks, Fairbanks, AK, USA
- University of Minnesota Medical School, Duluth Campus, MN, USA
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Werdin S, Wyss K. Challenges in the evaluation of suicide prevention measures and quality of suicide data in Germany, Austria, and Switzerland: findings from qualitative expert interviews. BMC Public Health 2024; 24:2209. [PMID: 39138493 PMCID: PMC11323587 DOI: 10.1186/s12889-024-19726-w] [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: 03/08/2024] [Accepted: 08/08/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Suicide prevention requires diverse, integrated, and evidence-based measures. Comprehensive evaluation of interventions and reliable suicide data are crucial for guiding policy-making and advancing suicide prevention efforts. This study aimed to analyze current issues and gaps in the evaluation of suicide prevention measures and the quality of suicide data in Germany, Austria, and Switzerland to derive specific recommendations for improvement. METHODS Online, semi-structured interviews were conducted with 36 experts in suicide prevention from Germany, Austria, and Switzerland, covering insights from policy, science, and practice. The interviews took place between September 2022 and February 2023, were audio-recorded, transcribed verbatim, and analyzed using the Framework method. RESULTS While solid evidence supports the effectiveness of some suicide prevention interventions, experts indicated that the evaluation of many other measures is weak. Conducting effectiveness studies in suicide prevention presents a range of methodological and practical challenges, including recruitment difficulties, choosing adequate outcome criteria, ethical considerations, and trade-offs in allocating resources to evaluation efforts. Many interviewees rated the quality of national suicide statistics in Germany, Austria, and Switzerland as comparatively high. However, they noted limitations in the scope, timeliness, and reliability of these data, prompting some regions to implement their own suicide monitoring systems. None of the three countries has national routine data on suicide attempts. CONCLUSION While some challenges in evaluating suicide prevention measures are inevitable, others can potentially be mitigated. Evaluations could be enhanced by combining traditional and innovative research designs, including intermediate outcomes and factors concerning the implementation process, and employing participatory and transdisciplinary research to engage different stakeholders. Reliable suicide data are essential for identifying trends, supporting research, and designing targeted prevention measures. To improve the quality of suicide data, a standardized monitoring approach, including uniform definitions, trained professionals, and cross-sector agreement on leadership and financing, should be pursued. This study provides actionable recommendations and highlights existing good practice approaches, thereby supporting decision-makers and providing guidance for advancing suicide prevention on a broader scale.
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Affiliation(s)
- Sophia Werdin
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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de Santiago-Díaz AI, Barrio-Martínez S, Gómez-Ruiz E, Carceller-Meseguer T, Sastre-Yañez J, Ortíz-García de la Foz V, Ayesa-Arriola R. Effectiveness of early and intensive intervention on suicide prevention: CARS programme. Psychiatry Res 2024; 338:115964. [PMID: 38824711 DOI: 10.1016/j.psychres.2024.115964] [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: 01/30/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
The aim of this study was to evaluate the outcomes of the Programme for Management of Suicidal Behaviour and Suicide Prevention (CARS). Individuals treated in the emergency department of University Hospital Marqués de Valdecilla for suicidal thoughts or attempts (N = 401) between 1-March-2016 and 31-December-2018 were considered. No randomization by patients or groups was performed. Student's t-test, chi-square and repeated measure analysis of variance were used. Kaplan-Meier survival function and Cox proportional hazard regression models were employed to estimate the risks of relapse. Outcome of those who voluntary enrol CARS were compared with treatment as usual (TAU) at 6- and 12-months follow-up. The results indicate a significant reduction and delayed occurrence of suicidal behaviour over a 12-month follow-up period with the CARS programme compared to TAU, along with a decreased frequency of hospital admissions. CARS programme demonstrates a substantial impact, significantly reducing the risk of recurrent suicidal behaviour by 35.5 % and the risk of repeated suicidal attempts by 47.2 % at the 12-month follow-up. The programme exhibits a dual protective effect, diminishing suicidal behaviour and fostering improved long-term outcomes. In conclusion, CARS effectively reduced suicidal behaviour recurrence, achieving significant decreases in suicidal thoughts, plans and attempts.
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Affiliation(s)
- Ana Isabel de Santiago-Díaz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain.
| | | | - Elsa Gómez-Ruiz
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Telva Carceller-Meseguer
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Javier Sastre-Yañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla (HUMV), Santander, Spain; Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | - Rosa Ayesa-Arriola
- Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.
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DeBeer B, Mignogna J, Talbot M, Villarreal E, Mohatt N, Borah E, Russell PD, Bryan CJ, Monteith LL, Bongiovanni K, Hoffmire C, Peterson AL, Heise J, Baack S, Weinberg K, Polk M, Benzer JK. Suicide Prevention Programming: Comparing Four Prominent Frameworks. Psychiatr Serv 2024; 75:789-800. [PMID: 38807579 DOI: 10.1176/appi.ps.20230173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Suicide is a significant public health concern. About 48,000 individuals died by suicide in 2021 in the United States, and approximately one in 100 deaths globally are due to suicide. Continuing efforts in program development and evaluation are vital to preventing suicide. Multiple frameworks have been developed to reduce suicide rates, but they have not been compared to assess their comprehensiveness, nor have their components been classified. METHODS In 2019, the authors conducted a narrative review of the literature and identified four major frameworks for suicide prevention: the U.S. Department of Veterans Affairs (VA) Suicide Prevention Program, the Defense Suicide Prevention Program of the U.S. Department of Defense, Zero Suicide in Health and Behavioral Health Care, and the technical package developed by the Centers for Disease Control and Prevention. Program components for these frameworks were identified and classified by using two prevention strategy classification systems: the National Academy of Medicine's (NAM's) continuum-of-care model and the Substance Abuse and Mental Health Services Administration's (SAMHSA's) prevention model. RESULTS The cross-program comparison revealed that no single program included all components of suicide prevention programs. However, the VA program was the most comprehensive in terms of the number of components and their spread across prevention strategy classifications. The programs used few components categorized under NAM's promotion or selective prevention strategy classifications. The SAMHSA prevention strategy classifications of information dissemination, community-based processes, and positive alternatives were also used infrequently. CONCLUSIONS Organizations, health care systems, and policy makers may use these findings as they develop, improve, and implement suicide prevention programs.
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Affiliation(s)
- Bryann DeBeer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Joseph Mignogna
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Margaret Talbot
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Edgar Villarreal
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Nathaniel Mohatt
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Elisa Borah
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Patricia D Russell
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Craig J Bryan
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Kathryn Bongiovanni
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Claire Hoffmire
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Alan L Peterson
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Jenna Heise
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Sylvia Baack
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Kimberly Weinberg
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Marcy Polk
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
| | - Justin K Benzer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center for Suicide Prevention, Eastern Colorado Veterans Affairs (VA) Health Care System, Aurora (DeBeer, Mignogna, Talbot, Russell, Monteith, Hoffmire); Department of Physical Medicine and Rehabilitation (DeBeer, Mignogna, Russell, Hoffmire) and Department of Psychiatry (Monteith), University of Colorado Anschutz Medical Campus, Aurora; Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs (Talbot); Office of Mental Health and Suicide Prevention, VA Central Office, Washington, D.C. (Villarreal); Division of Prevention and Community Research, Yale School of Medicine, New Haven (Mohatt); Booz Allen Hamilton, Arlington, Virginia (Mohatt); Steve Hicks School of Social Work and Dell Medical School (Borah) and Department of Psychiatry (Benzer), University of Texas at Austin, Austin; College of Medicine, Ohio State University, Columbus, and VA Veterans Integrated Services Network (VISN) 2 Center of Excellence, New York City (Bryan); VA VISN 17 Clinical Resource Hub, VA Texas Valley Coastal Bend Healthcare System, Harlingen (Bongiovanni); Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, and Research and Development Service, South Texas Veterans Health Care System, San Antonio (Peterson); Suicide Prevention Center of New York, Albany, and Zero Suicide Institute, Education Development Center, Waltham, Massachusetts (Heise); Michael E. DeBakey VA Medical Center, Houston (Baack); Central Texas VA Health Care System, Temple (Weinberg); VA Portland Healthcare System, Portland, Oregon (Polk); VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas (Benzer)
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Corrêa Matias Pereira C, Najafi Moghaddam Gilani V, Nazif-Munoz JI. A brief research report of suicide rates in the Brazilian elderly over a 12-year period: the lack of association of the " Setembro Amarelo" campaign for suicide prevention. Front Psychiatry 2024; 15:1354030. [PMID: 39119072 PMCID: PMC11306183 DOI: 10.3389/fpsyt.2024.1354030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Objectives Aiming to disseminate information related to suicide prevention in Brazil, the "Setembro Amarelo" campaign has been conducted since 2015. The objective of this study is to assess the association between this campaign and elderly suicide rates over a 12-year period. Methods Data were gathered from the Mortality Information System and the Notifiable Diseases Information System, established by public institutions in Brazil. An interrupted time-series framework was applied to assess the association between the "Setembro Amarelo" campaign and suicide mortality rates in the elderly population (60 et plus) in the southeastern region of Brazil. We consider three monthly outcomes: all suicides, suicides in males and suicide in females. We operationalize the campaign assuming three effects: short-term, declining and sustained. The period of analysis was from 2011-2022. Results The suicide-mortality rate over time has remained stable; the average rate in the pre-campaign period was 0.028 and increased slightly to 0.035. Regardless of the campaign's operationalization and the outcome used, results show no significant associations between the campaign and elderly suicide rates. The campaign was associated with non-significant decreased effects of 15% (P=0.532) in the short term, and 16% (P=0.446) assuming the campaign was sustained. Conclusions There is a lack of association between the campaign and suicide rates, among the elderly in Brazil's southeastern region. As suicide is complex and multifactorial, more research is needed. The campaign, while raising awareness and reducing stigma, may not reduce suicides. To reduce the suicide rate in the elderly requires addressing social, economic and cultural factors, multisectoral interventions, and upholding basic human rights.
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Affiliation(s)
- Camila Corrêa Matias Pereira
- Service sur les dépendances, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, QC, Canada
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7
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Kanapathy R, Agampodi T, Eddleston M, Konradsen F, Pearson M, Sanjula B, Malalasekara C, Naseer N, Agampodi S, Weerasinghe M. Exploring fidelity of enactment in a cluster randomised controlled trial testing the effectiveness of 'gatekeeper' training for pesticide vendors in reducing self-poisoning in rural Sri Lanka: protocol for a multimethod qualitative study. BMJ Open 2024; 14:e082688. [PMID: 38977371 PMCID: PMC11256041 DOI: 10.1136/bmjopen-2023-082688] [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: 11/30/2023] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Abstract
INTRODUCTION Pesticide self-poisoning causes severe health and socioeconomic hardship in low- and middle-income countries, including Sri Lanka. A stepped-wedge cluster randomised controlled trial (cRCT) has been designed to test whether 'gatekeeper' training for pesticide vendors reduces pesticide self-poisoning in rural Sri Lanka (Vendor cRCT). Ensuring intervention fidelity in RCTs is essential for consistently replicating interventions, accurately assessing their impact and improving outcomes. Thus, the overarching goal of this proposed study is to explore to what extent the pesticide vendors use the 'gatekeeper' strategies. METHODS AND ANALYSIS A multimethod qualitative research design is being used to explore the pesticide-selling behaviours of vendors after the 'gatekeeper' training. A subsample of the Vendor cRCT Study population is being recruited using a stratified purposive sampling method in all six intervention districts in Sri Lanka to ensure that the sample is representative of the pesticide vendors in the study area. Participant diaries, observations and focus group discussions are being adopted to collect data. Data triangulation will be performed and data will be analysed thematically. ETHICS AND DISSEMINATION The study was approved by the Ethics and Research Committee, Faculty of Medicine and Allied Sciences, at the Rajarata University of Sri Lanka (ERC/2023/09). All participants will provide informed consent. Findings will be disseminated in scientific peer-reviewed journals and conference presentations.
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Affiliation(s)
- Rajaratnam Kanapathy
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Thilini Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Flemming Konradsen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Melissa Pearson
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Central Clinical School, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Bimali Sanjula
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Charuni Malalasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Nasman Naseer
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Manjula Weerasinghe
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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8
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Probert-Lindström S, Bötschi S, Gysin-Maillart A. The Influence of Treatment Latency on Suicide-Specific Treatment Outcomes. Arch Suicide Res 2024; 28:1009-1021. [PMID: 37812204 DOI: 10.1080/13811118.2023.2265437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
INTRODUCTION The Attempted Suicude Short Intervention Program (ASSIP) provides an effective and cost-effective treatment option for people who have attempted suicide. Studies suggest that longer treatment latency is associated with poorer response to therapy, more severe symptomatology, and more suicide attempts This study examined the influence of treatment latency (time between suicide attempt and initiation of therapy) on the number of suicide attempts over the long-term course of ASSIP and the influence of treatment relationship on the extent of suicidal ideation. METHOD Survival and regression analyses were performed on 60 participants who had recently attempted suicide and received ASSIP at an outpatient psychiatric clinic. 60% were women and 40% were men. RESULTS The results found no significant association between treatment outcome in ASSIP and treatment latency (HR = 1.06; 95% CI: 0.92- 1.21, p = .44). Treatment relationship significantly influenced suicidal ideation at time t4 (B = - .35, t(55) = -3.21, p = .002), but treatment latency was not significantly associated with suicidal ideation (B = .02, t(55) = 0.87, p = .39). CONCLUSION No relationship between treatment latency and treatment outcome could be found, suggesting that ASSIP can be implemented at any time after the last suicide attempt. In contrast, the treatment relationship plays a central role in ASSIP.
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9
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Klimiuk KB, Krefta D, Krawczyk M, Balwicki Ł. Seasonal Trends in Suicide Attempts-Keywords Related Searches: A Google Trends Analysis. Healthcare (Basel) 2024; 12:1273. [PMID: 38998808 PMCID: PMC11241548 DOI: 10.3390/healthcare12131273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/17/2024] [Accepted: 06/23/2024] [Indexed: 07/14/2024] Open
Abstract
Suicide is a significant public health concern globally, with its varying rates influenced by numerous factors, including seasonal changes. Online search behaviors, particularly searches related to suicide and mental health, have been proposed as real-time indicators of suicidal ideation in populations. In this study, a cross-sectional time series analysis was conducted, utilizing data on suicide attempts from the Polish Police Headquarters and online search behavior from Google Trends over a decade. Suicide attempt data were analyzed alongside the frequency of Google searches for suicide-related keywords derived from the Polish Corpus of Suicide Notes. A total of 66 keywords were selected for analysis to identify seasonal trends and patterns in search behavior. The study employed linear regression, Seasonal Mann-Kendall tests, and TBATS models to analyze the data. Suicide rates show seasonal patterns, peaking in warmer months. However, keyword searches did not strongly correlate with peak suicide months. This study enhances our understanding of suicide-related search trends and their potential connection to suicide rates. It suggests avenues for more effective prevention efforts and the potential for future algorithms to predict suicide rates and identify at-risk groups.
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Affiliation(s)
- Krzysztof Bartosz Klimiuk
- Department of Public Health and Social Medicine, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dawid Krefta
- Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, 80-233 Gdańsk, Poland
| | - Michał Krawczyk
- Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Łukasz Balwicki
- Department of Public Health and Social Medicine, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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10
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Qu D, Zhu A, Chen R. Addressing the gender paradox: Effective suicide prevention strategies for women. Cell Rep Med 2024; 5:101613. [PMID: 38897169 PMCID: PMC11228777 DOI: 10.1016/j.xcrm.2024.101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024]
Abstract
The gender paradox in suicide research refers to the phenomenon that while males report higher suicide mortality, females suffer more from suicidal thoughts, leading to higher suicidal risks. This paradox may lead to the misconception that female suicides do not require as much attention. Therefore, there is an urgent need for researchers to shift their perspectives from the current male-centric approach to more inclusive knowledge for female suicidality. Following this, the current commentary emphasizes the importance of identifying and addressing the crucial but overlooked psychosocial factors underlying female suicidality. In addition, the ecological framework is employed as a guiding tool for exploring the intricate interplay of biological, psychological, societal, and cultural factors that are associated with female suicidality, thereby allowing researchers and stakeholders to develop more effective prevention and intervention strategies tailored to women's needs. Overall, this commentary calls for more refined and equitable approaches to suicide prevention that address the needs of individuals for all gender identities.
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Affiliation(s)
- Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Anni Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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Ali H, Hameed M, Abbasi MA, Ali A, Abbas Z, Rahim Valiyakath C, Ahmad Abbasi G, Qureshi AU, Kainaat M, Amer A. Ostracism Predicting Suicidal Behavior and Risk of Relapse in Substance Use Disorders. Cureus 2024; 16:e61519. [PMID: 38957263 PMCID: PMC11218481 DOI: 10.7759/cureus.61519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION The present study investigated the predictive relationship between ostracism and suicidal behaviors in individuals with substance use disorders. It also attempts to highlight the mediating role of the risk of relapse between ostracism and suicidal behavior. METHODS The study was based on a cross-sectional survey design. The sample comprised 100 men aged between 30 to 45 years (M = 35.25, SD = 3.06) from Karachi. The purposive sampling technique was employed. The study employed demographic forms and three self-reporting measures: the Ostracism Experience Scale (OES-A), the Advance Warning of Relapse Questionnaire 3.0 (AWARE), and the Suicide Behaviors Questionnaire-Revised (SBQ-R). RESULTS Ostracism significantly predicted relapse risk and suicidal behavior. Risk of relapse positively predicted both dimensions of ostracism (ignored: r = 0.33, p < 0.01; excluded: r = 0.43, p < 0.01) and suicidal behavior (r = 0.35, p < 0.01). Additionally, the risk of relapse strongly correlated with overall ostracism score (r = 0.43, p < 0.01). However, no significant mediating effect of ostracism on suicidal behavior was found. The effect was mediated through the risk of relapse (B indirect = 0.12, 95% CI = 0.04, 0.23). These findings suggest that ostracism increases the likelihood of recurrence, which in turn is associated with suicidal behavior. The mediation model explained 17% of the variation in suicidal behavior. CONCLUSION The findings propose the importance of addressing ostracism as a risk factor for suicidal behavior and relapse in substance use disorders. The results suggest that reducing the adverse effects of ostracism and improving social support for individuals can have a significant impact on their mental health.
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Affiliation(s)
- Habiba Ali
- Department of Clinical Psychology, University of Karachi, Karachi, PAK
| | - Muddsar Hameed
- Department of Clinical Psychology, Shifa Tameer e Millat University, Islamabad, PAK
| | - Mahrukh Anwar Abbasi
- Department of Internal Medicine, Foundation University Medical College, Rawalpindi, PAK
| | - Alishba Ali
- Department of Speech Pathology, Children's Hospital, Lahore, PAK
| | - Zamurd Abbas
- Department of Medicine, International European University, Bishkek, KGZ
| | | | - Gohar Ahmad Abbasi
- Department of Medicine, Shifa Tameer e Millat University, Islamabad, PAK
| | | | - Maryam Kainaat
- Department of Management, National University of Modern Languages, Islamabad, PAK
| | - Alishba Amer
- Department of Nutrition, Lahore Medical and Dental College, Lahore, PAK
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12
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Ajluni V, Amarasinghe D. Youth suicide crisis: identifying at-risk individuals and prevention strategies. Child Adolesc Psychiatry Ment Health 2024; 18:58. [PMID: 38783338 PMCID: PMC11119010 DOI: 10.1186/s13034-024-00753-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Victor Ajluni
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Daniel Amarasinghe
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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13
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Jenniskens K, Rasing S, Popma A, Creemers D, Ghalit C, van Vuuren L, Mérelle S, Spijker J, van Nassau F. Development of an implementation plan for a school-based multimodal approach for depression and suicide prevention in adolescents. Front Public Health 2024; 12:1386031. [PMID: 38799678 PMCID: PMC11122015 DOI: 10.3389/fpubh.2024.1386031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/12/2024] [Indexed: 05/29/2024] Open
Abstract
Strong Teens and Resilient Minds (STORM) is a multimodal, school-based approach for depression and suicide prevention in adolescents that is currently implemented in a region in the Netherlands. The STORM approach will be implemented in new regions in the coming years. This study used the implementation mapping protocol to report on the development of the STORM implementation plan. First, a needs assessment was conducted through semi-structured interviews with stakeholders and brainstorming sessions with regional programme leaders in the two regions that started implementing STORM in 2023. This led to the identification of six main barriers to implementation: high level of demands for schools, insufficient understanding of the programme content, insufficient network collaboration, no perceived relative advantage of STORM by stakeholders, lack of attention to sustainability, and high work pressure. Second, performance and change objectives were formulated based on these barriers. For example, a performance objective for potential providers was that they felt supported by STORM. Third, implementation strategies were selected from theory and translated into practical applications through brainstorming sessions with programme leaders. The following strategies were included in the implementation plan: collaborate with similar initiatives within the region, free up time for STORM tasks, tailor strategies, identify and prepare STORM champions, and promote network weaving. Last, a plan to evaluate the implementation of STORM and the application of the STORM implementation plan was formulated. Planned evaluation research will provide more insight into the usefulness and impact of the STORM implementation plan.
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Affiliation(s)
- Kristel Jenniskens
- GGZ Oost Brabant, Boekel, Netherlands
- 113 Suicide Prevention, Amsterdam, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Sanne Rasing
- GGZ Oost Brabant, Boekel, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, Netherlands
| | - Daan Creemers
- GGZ Oost Brabant, Boekel, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Chaimae Ghalit
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, Netherlands
| | | | | | - Jan Spijker
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Pro Persona, Nijmegen, Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, Netherlands
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14
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Xu X, Song J, Jia L. The influence of psychotherapy on individuals who have attempted suicide: A systematic review and meta-analysis. J Psychiatr Ment Health Nurs 2024. [PMID: 38619529 DOI: 10.1111/jpm.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Suicide is a serious global public health issue, and a history of attempted suicide is the most critical indicator of suicide risk. There are limited studies on the effectiveness of psychotherapy in individuals who have attempted suicide, and other outcome measures related to suicide risk in suicide attempts have not been explored. AIM/QUESTION This study aimed to systematically review and perform a meta-analysis of the effectiveness of psychotherapy on individuals who have attempted suicide. METHODS This study conducted a comprehensive literature search of five major databases (PubMed, EMBASE, Cochrane, Web of Science, and Ovid). The protocol for this study is registered with PROSPERO (CRD42023464401) and follows the PRISMA guidelines. RESULTS This meta-analysis included a total of 34 trials from 32 literature sources. The study involved a total of 6600 participants. The results showed that psychotherapy had a positive effect on reducing the suicidal tendencies of individuals who have attempted suicide and effectively reduced the number of repeated suicide attempts as well as the levels of suicidal ideation, depression, anxiety and hopelessness. IMPLICATIONS FOR PRACTICE This study concludes that psychotherapy is effective in reducing the suicidal tendencies of individuals who have attempted suicide. Psychological therapy for individuals who have attempted suicide are crucial in preventing future suicidal behaviours.
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Affiliation(s)
- Xinqing Xu
- Department of Psychology, Shandong Second Medical University, Weifang, China
| | - Jingjing Song
- Department of Psychology, Shandong Second Medical University, Weifang, China
| | - Liping Jia
- Department of Psychology, Shandong Second Medical University, Weifang, China
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15
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Martínez-Rives NL, Martín Chaparro MDP, Dhungel B, Gilmour S, Colman RD, Kotera Y. Suicide Interventions in Spain and Japan: A Comparative Systematic Review. Healthcare (Basel) 2024; 12:792. [PMID: 38610214 PMCID: PMC11011319 DOI: 10.3390/healthcare12070792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/24/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components.
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Affiliation(s)
| | | | - Bibha Dhungel
- School of International Liberal Studies, Waseda University, Tokyo 169-0051, Japan;
- Department of Health Policy, National Centre for Child Health and Development, Tokyo 157-0074, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan;
| | - Rory D. Colman
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK;
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK;
- Center for Infectious Disease Education and Research, Osaka University, Suita 565-0871, Japan
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Üzer A, Uran C, Yılmaz E, Şahin ŞN, Ersin MK, Yılmaz RH, Çıkla A. The relationship between chronotype, psychological pain, problematic social media use, and suicidality among university students in Turkey. Chronobiol Int 2024; 41:504-512. [PMID: 38373906 DOI: 10.1080/07420528.2024.2320226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
Chronotype has been extensively linked to various psychological outcomes, including suicide, which significantly impacts the mortality rate among young adults worldwide. Research on the extent of these links is still ongoing. This cross-sectional study aimed to explore the complex relationships between chronotype, internet addiction, problematic social media use (PSMU), psychological pain, and suicidality in a student population. A total of 571 Turkish students (65.3% female, mean age 20.3 ± 1.63 years) completed the following scales: the Suicide Probability Scale (SPS), the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS), the Social Media Disorder Scale (SMDS), the Internet Addiction Test (IAT), the Morningness - Eveningness Questionnaire (MEQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the relationship between chronotype and suicidality was partially mediated by SMDS and MBPPAS but not by anxiety, depression, or IAT. These findings suggest that psychological pain and PSMU may be important factors that contribute to suicidality in evening-type individuals. These findings have significant implications for the development of interventions aimed at reducing suicidality among evening-type individuals. By addressing the underlying factors of psychological pain and PSMU, it may be possible to mitigate the increased risk of suicidality among this population.
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Affiliation(s)
- Ahmet Üzer
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ceren Uran
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Elif Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Şeima Nur Şahin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Muhammet Kaan Ersin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rohat Hasret Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ayça Çıkla
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Spahn C, Spangenberg L, Teismann T, Forkmann T, Schönfelder A, Schreiber D, Paashaus L, Stengler K, Glaesmer H. [Utilization of Outpatient Psychotherapy and Outpatient Psychiatric Treatment by Men and Women after Inpatient Treatment due to Suicide Attempt or Acute Suicidal Crisis]. PSYCHIATRISCHE PRAXIS 2024; 51:99-103. [PMID: 37813362 DOI: 10.1055/a-2163-1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The strongest predictor of suicide attempts is a previous suicide attempt. Individuals hospitalized for suicidal ideation and behavior face an increased risk of suicide following discharge. This study investigates the extent to which outpatient treatment services are utilized the first 6 months after discharge and whether men and women differ in this regard. METHOD The study examines data of 124 individuals (with suicide attempts (lifetime), 59.7% female) on the use of outpatient treatment services in the 6 months after inpatient treatment. RESULTS 37.9% (N=47) of individuals reported not having used any treatment services at all. Men were significantly less likely to make use of the services. CONCLUSION Members of a group with an increased risk of suicide, to a large extent, fail to make use of outpatient treatment services. Discharge management should increasingly focus on (gender-specific) barriers and pave the way for treatment in outpatient.
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Affiliation(s)
- Cora Spahn
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Lena Spangenberg
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Tobias Teismann
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum
| | - Thomas Forkmann
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | - Antje Schönfelder
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - Dajana Schreiber
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | - Laura Paashaus
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Duisburg-Essen
| | | | - Heide Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
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18
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Chen JI, Roth B, Dobscha SK, Lowery JC. Implementation strategies in suicide prevention: a scoping review. Implement Sci 2024; 19:20. [PMID: 38409000 PMCID: PMC10895723 DOI: 10.1186/s13012-024-01350-2] [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: 10/26/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Implementation strategies can be a vital leveraging point for enhancing the implementation and dissemination of evidence-based suicide prevention interventions and programming. However, much remains unknown about which implementation strategies are commonly used and effective for supporting suicide prevention efforts. METHODS In light of the limited available literature, a scoping review was conducted to evaluate implementation strategies present in current suicide prevention studies. We identified studies that were published between 2013 and 2022 that focused on suicide prevention and incorporated at least one implementation strategy. Studies were coded by two independent coders who showed strong inter-rater reliability. Data were synthesized using descriptive statistics and a narrative synthesis of findings. RESULTS Overall, we found that studies most commonly utilized strategies related to iterative evaluation, training, and education. The majority of studies did not include direct measurement of suicide behavior outcomes, and there were few studies that directly tested implementation strategy effectiveness. CONCLUSION Implementation science strategies remain an important component for improving suicide prevention and intervention implementation. Future research should consider the incorporation of more type 3 hybrid designs as well as increased systematic documentation of implementation strategies. TRIAL REGISTRATION < de-identified > .
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Affiliation(s)
- Jason I Chen
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, U.S. Department of Veterans Affairs (VA), Portland, OR, USA.
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, USA.
| | - Brandon Roth
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, U.S. Department of Veterans Affairs (VA), Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, USA
- Portland VA Research Foundation, Portland, OR, USA
| | - Steven K Dobscha
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, U.S. Department of Veterans Affairs (VA), Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - Julie C Lowery
- Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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Rabasco A, Arias S, Benz MB, Weinstock LM, Miller I, Boudreaux ED, Camargo CA, Kunicki ZJ, Gaudiano BA. Longitudinal risk of suicide outcomes in people with severe mental illness following an emergency department visit and the effects of suicide prevention treatment. J Affect Disord 2024; 347:477-485. [PMID: 38065475 PMCID: PMC10872614 DOI: 10.1016/j.jad.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/29/2023] [Accepted: 12/02/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Individuals with severe mental illness (SMI), including bipolar disorder (BD) and schizophrenia-spectrum disorders (SSD), are at high risk for suicide. However, suicide research often excludes individuals with SMI. The current research examined differences in suicide outcomes (i.e., suicide attempt or death) for adults with and without BD and SSD diagnoses following an emergency department (ED) visit and investigated the efficacy of the Coping Long Term with Active Suicide Program (CLASP) intervention in reducing suicide outcomes among people with SMI. METHODS 1235 adults presenting with recent suicidality were recruited from 8 different EDs across the United States. Using a quasi-experimental, stepped wedge series design, participants were followed for 52-weeks with or without subsequent provision of CLASP. RESULTS Participants in the SSD group and the BD group had significantly shorter time to and higher rate of suicide outcomes than participants with other psychiatric diagnoses in all study phases and in non-CLASP phases, respectively. Participants with BD receiving the CLASP intervention had significantly longer time to suicide outcomes than those not receiving CLASP; these differences were not observed among those with SSD. LIMITATIONS Study limitations include self-reported psychiatric diagnosis, exclusion of homeless participants, and small sample size of participants with SSD. CONCLUSIONS Participants with SMI were at higher risk for suicide outcomes than participants with other psychiatric diagnoses. CLASP was efficacious among those participants with BD. Psychiatric diagnosis may be a key indicator of prospective suicide risk. More intensive and specialized follow-up mental health treatment may be necessary for those with SSD.
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Affiliation(s)
- Ana Rabasco
- Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA.
| | - Sarah Arias
- Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA
| | - Madeline B Benz
- Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA
| | | | - Ivan Miller
- Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA
| | | | - Carlos A Camargo
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Zachary J Kunicki
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brandon A Gaudiano
- Warren Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA
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Fekih-Romdhane F, Malaeb D, Farah N, Stambouli M, Cheour M, Obeid S, Hallit S. The relationship between cyberbullying perpetration/victimization and suicidal ideation in healthy young adults: the indirect effects of positive and negative psychotic experiences. BMC Psychiatry 2024; 24:121. [PMID: 38355556 PMCID: PMC10865539 DOI: 10.1186/s12888-024-05552-2] [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: 06/11/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Even though not all cyber bullies or victims think of (or consider) suicide, they clearly appear to be at an increased risk. One possible strategy to reduce suicide risk is to decrease cyberbullying occurrence; but this approach has its limitations, as it is certainly an illusion to believe that cyberbullying could be controlled or eliminated in a digitalized world. Another alternative and interesting strategy is to consider mediating factors that may indirectly affect suicidality. To this end, our purpose was to test the hypothesis that positive and negative psychotic experiences (PEs) mediate the relationship from cyberbullying perpetration/victimization to suicidal ideation (SI). METHOD The study followed a cross-sectional design, and was conducted during the period from June to September 2022. A total of 3103 healthy community participants from Lebanon were included (mean age 21.73 ± 3.80 years, 63.6% females). RESULTS After adjusting over potential confounders, mediation analysis models showed that both positive and negative PEs partially mediated the associations between cyberbullying victimization/perpetration and SI. Higher cyberbullying perpetration and victimization were significantly associated with greater positive and negative PEs; more severe positive and negative PEs were significantly associated with higher levels of SI. Higher cyberbullying victimization and perpetration were significantly and directly associated with higher levels of SI. CONCLUSION In light of our preliminary findings, there appears to be an urgent need for a new focus on carefully assessing and addressing attenuated psychotic symptoms in healthy individuals engaged in cyberbullying either as victims or bullies and who present with SI. It is important that school counselors and decision-makers consider a holistic approach taking into account both external/environmental (bullying) and internal/individual (PEs) factors in their suicide prevention programs. Future longitudinal research in larger samples are still required to confirm our findings and further elucidate the mechanisms underlying the relationship between cyberbullying and suicide.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia.
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
- Psychology Department, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Meda N, Miola A, Cattarinussi G, Sambataro F. Whole-brain structural and functional neuroimaging of individuals who attempted suicide and people who did not: A systematic review and exploratory coordinate-based meta-analysis. Eur Neuropsychopharmacol 2024; 79:66-77. [PMID: 38237538 DOI: 10.1016/j.euroneuro.2023.10.003] [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: 07/10/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 02/06/2024]
Abstract
Suicide is the cause of death of approximately 800,000 people a year. Despite the relevance of this behaviour, risk assessment tools rely on clinician experience and subjective ratings. Given that previous suicide attempts are the single strongest predictors of future attempts, we designed a systematic review and coordinate-based meta-analysis to demonstrate whether neuroimaging features can help distinguish individuals who attempted suicide from subjects who did not. Out of 5,659 publications from PubMed, Scopus, and Web of Science, we summarised 102 experiments and meta-analysed 23 of them. A cluster in the right superior temporal gyrus, a region implicated in emotional processing, might be functionally hyperactive in individuals who attempted suicide. No statistically significant differences in brain morphometry were evidenced. Furthermore, we used JuSpace to show that this cluster is enriched in 5-HT1A heteroreceptors in the general population. This exploratory meta-analysis provides a putative neural substrate linked to previous suicide attempts. Heterogeneity in the analytical techniques and weak or absent power analysis of the studies included in this review currently limit the applicability of the findings, the replication of which should be prioritised.
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Affiliation(s)
- Nicola Meda
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova University Hospital, Padua, Italy
| | - Alessandro Miola
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Casa di Cura Parco dei Tigli, Padova, Italy
| | - Giulia Cattarinussi
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova University Hospital, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy.
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Minian N, Gayapersad A, Coroiu A, Dragonetti R, Zawertailo L, Zaheer J, O’Neill B, Lange S, Thomson N, Crawford A, Kennedy SH, Selby P. Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Front Psychiatry 2024; 15:1286078. [PMID: 38333892 PMCID: PMC10850298 DOI: 10.3389/fpsyt.2024.1286078] [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: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Gayapersad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adina Coroiu
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Juveria Zaheer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Braden O’Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Arthur Sommer Rotenberg Program in Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Fröding E, Vincent C, Andersson-Gäre B, Westrin Å, Ros A. Six Major Steps to Make Investigations of Suicide Valuable for Learning and Prevention. Arch Suicide Res 2024; 28:1-19. [PMID: 36259504 DOI: 10.1080/13811118.2022.2133652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. To be an effective tool, revisions of the current investigation methods are required. This review aimed to describe the problems with the current approaches to investigations of suicide as patient harm and to propose ways to move forward. METHODS Narrative literature review. RESULTS Several weaknesses in the current approaches to investigations were identified. These include failures in embracing patient and system perspectives, not addressing relevant factors, and insufficient competence of the investigation teams. Investigation methods need to encompass the progress of knowledge about suicidal behavior, suicide prevention, and patient safety. CONCLUSIONS There is a need for a paradigm shift in the approaches to investigations of suicide as potential patient harm to enable learning and insights valuable for healthcare improvement. Actions to support this paradigm shift include involvement of patients and families, education for investigators, multidisciplinary analysis teams with competence in and access to relevant parts across organizations, and triage of cases for extensive analyses. A new model for the investigation of suicide that support these actions should facilitate this paradigm shift.HIGHLIGHTSThere are weaknesses in the current approaches to investigations of suicide.A paradigm shift in investigations is needed to contribute to a better understanding of suicide.New knowledge of suicidal behavior, prevention, and patient safety must be applied.
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Macdonald D, Nicolopoulos A, Habak S, Christensen H, Boydell K. Suicidal Emotions, Motivations and Rationales in Australian Men: A Qualitative Exploration. Glob Qual Nurs Res 2024; 11:23333936241242915. [PMID: 38572389 PMCID: PMC10989048 DOI: 10.1177/23333936241242915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/10/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide has a devasting and far-reaching effect on our communities. In developed countries, most people who die by suicide are male. Understanding men's mental health and what they experience in a suicidal state is key to preventing future attempts. Our paper explores how a group of 37 men in Australia describe the leadup to their suicidality. Underpinned by interpretive phenomenological analysis, interview transcripts were examined for phrases that the investigative team subjectively identified as profound. Our approach considered language and expression that evoke reactions to the sometimes contradictory nature of suicide. The process enabled our team to identify the emotions, rationales, and motivations for and against suicide that give rise to and arise during suicidal states. One man's source of strength may be another's cause of anguish, so any single, one-size-fits-all pathway to suicide prevention is unlikely to succeed, signaling the need for a tailored approach to suicide prevention.
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Affiliation(s)
- Diane Macdonald
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | | | - Stephanie Habak
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Helen Christensen
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Katherine Boydell
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
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Drago A. Genetic signatures of suicide attempt behavior: insights and applications. Expert Rev Proteomics 2024; 21:41-53. [PMID: 38315076 DOI: 10.1080/14789450.2024.2314143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Every year about 800,000 complete suicide events occur. The identification of biologic markers to identify subjects at risk would be helpful in targeting specific support treatments. AREA COVERED A narrative review defines the meta-analytic level of current evidence about the biologic markers of suicide behavior (SB). The meta-analytic evidence gathered so far indicates that the hypothesis-driven research largely failed to identify the biologic markers of suicide. The most consistent and replicated result was reported for: 1) 5-HTR2A T102C, associated with SB in patients with schizophrenia (OR = 1.73 (1.11-2.69)) and 2) BDNF Val66Met (rs6265), with the Met-Val + Val-Val carriers found to be at risk for suicide in the Caucasian population (OR: 1.96 (1.58-2.43)), while Val-Val vs. Val-Met + Met carriers found to be at risk for suicide in the Asian populations (OR: 1.36 (1.04-1.78)). GWAS-based meta-analyses indicate some positive replicated findings regarding the DRD2, Neuroligin gene, estrogen-related genes, and genes involved in gene expression. EXPERT OPINION Most consistent results were obtained when analyzing sub-samples of patients. Some promising results come from the implementation of the polygenic risk score. There is no current consensus about an implementable biomarker for SB.
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Affiliation(s)
- Antonio Drago
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
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Richard O, Jollant F, Billon G, Attoe C, Vodovar D, Piot MA. Simulation training in suicide risk assessment and intervention: a systematic review and meta-analysis. MEDICAL EDUCATION ONLINE 2023; 28:2199469. [PMID: 37073473 PMCID: PMC10120456 DOI: 10.1080/10872981.2023.2199469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Suicide is a major cause of preventable death worldwide. Adequate training in risk assessment and intervention is key to suicide prevention. The use of simulation (role plays, simulated patients, virtual reality…) for practical training is a promising tool in mental health. The purpose of this study was to assess the effectiveness of simulation training in suicide risk assessment and intervention for healthcare professionals and gatekeepers. METHODS We conducted a systematic review in Medline and PsycINFO up to 31 July 2021 of randomized controlled trials (RCTs), non-randomized controlled trials, and pre/post-test studies. RCTs were furthermore included in a meta-analysis. We assessed the methodological quality of all studies with the Medical Education Research Study Quality Instrument, and the Cochrane Risk of Bias tool 2.0 for RCTs. Primary outcomes were changes in Kirkpatrick criteria: attitudes, skills, knowledge, behaviors, and patient outcomes. RESULTS We included 96 articles representing 43,656 participants. Most pre/post-test (n = 65) and non-randomized controlled (n = 14) studies showed significant improvement in attitudes, skills, knowledge, and behaviors. The meta-analysis of 11 RCTs showed positive changes in attitudes immediately after training and at 2-4 months post-training; in self-perceived skills at 6 months post-training; but not in factual knowledge. Studies assessing benefits for patients are still limited. CONCLUSIONS The heterogeneity of methodological designs, interventions, and trained populations combined with a limited number of RCTs and studies on patients' outcomes limit the strength of the evidence. However, preliminary findings suggest that simulation is promising for practical training in suicidal crisis intervention and should be further studied.
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Affiliation(s)
- Océane Richard
- Department of child and adolescent psychiatry,Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades, Reference center for autism and learning disorders, Paris, France
| | - Fabrice Jollant
- Department of psychiatry, CHU Bicêtre, APHP, Le Kremlin-Bicêtre, France; Department of psychiatry, CHU Nimes, Nimes, France; Department of Psychiatry, School of Medicine, Paris-Saclay University, le Kremlin-Bicêtre, France; McGill University, McGill Group for Suicide Studies, Montreal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - Grégoire Billon
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Chris Attoe
- Mental helath simulation center, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dominique Vodovar
- Université Paris Cité, UFR de médecine, 75010 Paris; UMRS 1144, Faculté de pharmacie, 75006 Paris; Centre AntiPoison de Paris, Paris
| | - Marie-Aude Piot
- Department of child and adolescent psychiatry, Université Paris Cité, AP-HP, Academic Hospital Necker-Enfants Malades Reference center for autism and learning disorders; Ilumens, Simulation Center; Paris-Saclay University, Paris, France
- CONTACT Marie-Aude Piot Department of child and adolescent psychiatry, Academic Hospital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
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Larkin C, Arensman E, Boudreaux ED. Preventing Suicide in Health Systems: How Can Implementation Science Help? Arch Suicide Res 2023; 27:1147-1162. [PMID: 36267036 DOI: 10.1080/13811118.2022.2131490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Suicide prevention is an emotive, complex goal for clinicians and health systems. Effective interventions for suicidality do exist; however, many patients do not receive them because implementation efforts tend to be time-limited and unsystematic. Implementation science is the study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice. This narrative review introduces implementation science to suicide researchers, with a special focus on healthcare settings. We outline prominent theories, methods, and measures, as well as examples of implementation research from suicidology. By embracing the principles of implementation science, suicidologists can help to close the gap between evidence-based practice and routine practice, thereby improving the delivery and uptake of suicide-related interventions and prevention programs.
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Rajguru AJ, Balhara YPS. Increasing trend of deaths due to suicide attributable to mental disorders and substance use (disorders) in India. Asian J Psychiatr 2023; 88:103722. [PMID: 37579548 DOI: 10.1016/j.ajp.2023.103722] [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: 06/26/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/16/2023]
Abstract
In this article we aim to assess the change in the deaths due to suicide attributable to mental disorders and substance use (disorders) in India over the past 26 years. We also aim to make projections over the coming years. For the deaths due to suicide attributable to mental disorders there was a biquadratic increasing trend with equations predicting 85.97%, 90.76% and 85.79% variance in the males, females and total deaths, respectively. There was a quadratic increase explaining 94.83% variance in males, 61.79% in females and 95.41% variance in deaths due to suicide attributable to substance use (disorders).
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Affiliation(s)
- Akanksha Jayant Rajguru
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Yatan Pal Singh Balhara
- Behavioral Addictions Clinic (BAC), National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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Tsuchida T, Takahashi M, Mizugaki A, Narita H, Wada T. Differences in acute outcomes of suicide patients by psychiatric disorder: Retrospective observational study. Medicine (Baltimore) 2023; 102:e35065. [PMID: 37746963 PMCID: PMC10519571 DOI: 10.1097/md.0000000000035065] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
Suicide is a social problem with significant economic losses, the victims of which are mainly from the productive population. There are numerous reports on the assessment of suicide risk, but most focus on long-term management. Therefore, factors influencing the severity of physical impairments in the acute phase and the prognosis of suicidal patients have not been sufficiently investigated. This is a single-center retrospective observational study. We collected data on suicidal patients admitted to our emergency department. The effect of age, gender, psychiatric history, method of suicide, alcohol consumption, and hospital admission on the outcome of suicide was assessed. Outcomes were assessed using the hospital mortality scale and the cerebral performance category scale for in-hospital mortality within 28 days. Methods of suicide with a high mortality rate (hanging, jumping, carbon monoxide poisoning, and burns) were defined as lethal methods. A detailed risk assessment of outcomes was performed for patients with schizophrenia, mood disorders, and somatoform disorders. We identified 340 suicide patients from computerized medical records and analyzed 322 records without missing data. The non-survivor group predominantly comprised older adults, men, and patients without a history of psychiatric treatment. Contrastingly, more patients drank alcohol before suicide in the survivor group. In the subgroup analysis, patients with schizophrenia had unfavorable neurological outcomes. Patients with mood disorders had worse in-hospital mortality than other psychiatric patients, as did patients who chose the lethal method. By disease, patients with stress-related and somatoform disorders tended to have higher survival rates, although their psychiatric hospitalization rates were lower. Conversely, patients with mood disorders had a higher rate of hospital visits but a lower survival rate. The results suggest that usual outpatient treatment alone may not be sufficient to reduce suicide mortality in patients with mood disorders who are considered to be at high risk of suicide.
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Affiliation(s)
- Takumi Tsuchida
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Masaki Takahashi
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Asumi Mizugaki
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takeshi Wada
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Cliffe B, Gore-Rodney J, Linton MJ, Biddle L. Developing Suicide Prevention Tools in the Context of Digital Peer Support: Qualitative Analysis of a Workshop With Multidisciplinary Stakeholders. JMIR Form Res 2023; 7:e47178. [PMID: 37728967 PMCID: PMC10551794 DOI: 10.2196/47178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/28/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Suicide is the fourth leading cause of death among young people aged 15-29 years worldwide and suicide rates are increasing. Suicide prevention strategies can be effective but young people face barriers to accessing them. Providing support digitally can facilitate access, but this can also pose risks if there is inappropriate or harmful content. Collaborative approaches are key for developing digital suicide prevention tools to ensure support is appropriate and helpful for young people. Tellmi (previously MeeToo) is a premoderated UK-based peer-support app where people aged 11-25 years can anonymously discuss issues ranging from worries to life challenges. It has procedures to support high-risk users, nevertheless, Tellmi is interested in improving the support they provide to users with more acute mental health needs, such as young people struggling with suicide and self-harm ideation. Further research into the best ways of providing such support for this population is necessary. OBJECTIVE The aim of this study is to explore the key considerations for developing and delivering digital suicide prevention tools for young people aged 18-25 years from a multidisciplinary perspective, including the views of young people, practitioners, and academics. METHODS A full-day, in-person workshop was conducted with mental health academics (n=3) and mental health practitioners (n=2) with expertise in suicide prevention, young people with lived experience of suicidal ideation (n=4), and a computer scientist (n=1) and technical staff from the Tellmi app (n=6). Tellmi technical staff presented 14 possible evidence-based adaptations for the app as a basis for the discussions. A range of methods were used to evaluate them, including questionnaires to rate the ideas, annotating printouts of the ideas with post-it notes, and group discussions. A reflexive thematic analysis was performed on the qualitative data to explore key considerations for designing digital suicide prevention tools in the context of peer support. RESULTS Participants discussed the needs of both those receiving and providing support, noting several key considerations for developing and delivering digital support for high-risk young people. In total, four themes were developed: (1) the aims of the app must be clear and consistent, (2) there are unique considerations for supporting high-risk users: (subtheme) customization helps tailor support to high-risk users, (3) "progress" is a broad and multifaceted concept, and (4) considering the roles of those providing support: (subtheme) expertise required to support app users and (subtheme) mitigating the impact of the role on supporters. CONCLUSIONS This study outlined suggestions that may be beneficial for developing digital suicide prevention tools for young people. Suggestions included apps being customizable, transparent, accessible, visually appealing, and working with users to develop content and language. Future research should further explore this with a diverse group of young people and clinicians.
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Affiliation(s)
- Bethany Cliffe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Myles-Jay Linton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Cronn SE, Kant JM, Brandolino A, Kohlbeck S, deRoon-Cassini T, Emerson N, Schramm A. Suicide Data in Trauma Centers: Implications of Imprecision. J Trauma Nurs 2023; 30:255-260. [PMID: 37702726 DOI: 10.1097/jtn.0000000000000739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND Trauma registries exist to provide data for evaluating the quality of care of trauma patients. These data facilitate research and can be used for outreach, planning, and improvement in trauma patient outcomes. However, the accuracy of registry data related to suicide has not been well studied. OBJECTIVE This study sought to evaluate the accuracy of current trauma registry coding practices related to labeling injury as a suicide attempt among patients presenting to a Level I trauma center after self-inflicted injury. METHODS We conducted a single-center, retrospective cohort analysis of a Level I trauma center trauma registry on all patients with self-inflicted injuries from 2011 to 2021. Manual chart review was used to identify cases wherein patients' injuries were categorized as suicidal despite the absence of suicidal intent. RESULTS During this 11-year period, 537 patients were identified as having presented to the trauma center for traumatic self-inflicted injuries. Manual chart review revealed that 16% of these patients were incorrectly categorized as having attempted suicide despite their self-inflicted injury lacking suicidal intent (e.g., accidents, nonsuicidal self-harm). CONCLUSION We found that 16% of trauma registry patients were overcategorized as having attempted suicide. Trauma registry data are an important source of information for activities related to injury prevention in trauma centers. Imprecise coding of self-inflicted injury may lead to poorly targeted programs and interventions due to incorrectly represented injury causes and patterns in trauma patient populations, including suicide prevention.
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Affiliation(s)
- Susan E Cronn
- Division of Trauma & Acute Care Surgery, Department of Surgery (Drs Cronn, deRoon-Cassini, and Schramm and Ms Brandolino), and Comprehensive Injury Center (Drs Cronn, Kohlbeck, and Schramm and Ms Kant), Medical College of Wisconsin, Milwaukee; and Froedtert Hospital, Milwaukee, Wisconsin (Mr Emerson)
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van der Feltz-Cornelis CM, Hofstra E, Elfeddali I, Bakker M, Metz MJ, de Jong JJ, van Nieuwenhuizen C. Efficacy of a digitally supported regional systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands. Gen Hosp Psychiatry 2023; 84:73-81. [PMID: 37399647 DOI: 10.1016/j.genhosppsych.2023.06.010] [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: 03/29/2023] [Revised: 06/02/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE We evaluated the effect of a digitally supported systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands. METHOD Non-randomized stepped wedge trial design (SWTD). Stepwise implementation in the five subregions of the systems intervention. Pre-post analysis for the whole province (Exact Rate Ratio Test, Poisson count). SWTD Hazard Ratios of suicides per person-years for subregional analysis of control versus intervention conditions over five times three months. Sensitivity analysis. RESULTS Suicide rates dropped 17.8% (p = .013) from 14.4 suicides per 100,000 before the start of implementation of the systems intervention (2017), to 11.9 (2018) and 11.8 (2019) per 100, during implementation; a significant reduction (p = .043) compared to no changes in the rest of the Netherlands. Suicide rates dropped further by 21.5% (p = .002) to 11.3 suicides per 100,000 during sustained implementation in 2021. Sensitivity analysis confirmed the reduction (p = .02). The SWTD analysis over 15 months in 2018-2019 did not show a significant association of this reduction with implementation per subregional level, probably due to insufficient power given the short SWTD timeframe for implementation and low suicide rates per subregion. CONCLUSIONS During the SUPREMOCOL systems intervention, over four years, there was a sustained and significant reduction of suicides in Noord-Brabant.
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Affiliation(s)
- Christina M van der Feltz-Cornelis
- Mental Health and Addiction Research Group, Department of Health Sciences, Hull York Medical School, University of York, York, UK; Institute of Health Informatics, University College London, London, United Kingdom.
| | - Emma Hofstra
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, Netherlands
| | - Iman Elfeddali
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, Netherlands; Specialized Mental Health Institution, GGz Breburg, Tilburg, Netherlands
| | - Marjan Bakker
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Margot J Metz
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, Netherlands; Specialized Mental Health Institution, GGz Breburg, Tilburg, Netherlands
| | - Jacobus J de Jong
- Specialized Mental Health Institution, GGz Breburg, Tilburg, Netherlands
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Kassaw C, Alemayehu S. The Trends of Suicidality Over the Past 10 Years (1999-2022) in the Ethiopian General Population and the Way Forward in Tackling It. Psychol Res Behav Manag 2023; 16:3231-3236. [PMID: 37599797 PMCID: PMC10439282 DOI: 10.2147/prbm.s419426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
Suicide is defined as a death caused by willful acts of taking one's own life. It might be a way for people to get away from suffering or anguish. Globally, an estimated a million people individuals lose their life due to suicide annually. Before the age of 50 years old more than half (58%) of all suicide deaths occur. This commentary aims to highlight the Ethiopian context, feasible preventive measures, and the way forward in tackling suicidal behavior. Worldwide in adolescent age groups between the ages of 15 and 29, suicide is the fourth leading cause of death. Even though suicide occurs everywhere in the world, according to data in 2019, 77% of all suicides that occurred in the world reside in developing countries. Due to the numerous psychosocial pressures present in Ethiopia, one in four citizens suffers from a mental disorder. According to Ethiopian national data figures, suicide ideation affects 9%, 5-16% of people, whereas suicidal attempt affects 4%, 1-8%. Even though, there is a variation of prevalence over the years based on the variation in design, settings, and sample size. There is an increment in the prevalence's suicidal ideation and attempts in the past 10 years. The country's Ministry of Health needs to act to address and prevent this urgent public health situation. The prevention of suicide should be a top concern, and working with numerous stakeholders is an efficient and practical approach.
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Affiliation(s)
| | - Selamawit Alemayehu
- Departments of Psychiatry, St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Bommersbach TJ, Rosenheck RA, Rhee TG. Rising Rates of Suicidal Behaviors and Large Unmet Treatment Needs Among US Adults With a Major Depressive Episode, 2009 to 2020. Mayo Clin Proc 2023; 98:969-984. [PMID: 37419587 DOI: 10.1016/j.mayocp.2023.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/16/2023] [Accepted: 02/14/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE To examine recent 12-year trends in the incidence of suicidal ideation (SI) and suicide attempts (SAs) and receipt of mental health treatment among individuals experiencing a past-year major depressive episode (MDE). PATIENTS AND METHODS Using data from the National Survey of Drug Use and Health, we estimated the annual percentage of individuals with MDE who reported past-year SI or SAs and their use of mental health services from 2009 to 2020 and calculated odds ratios (ORs) for longitudinal change adjusting for potentially confounding factors. RESULTS During our study period, the weighted unadjusted proportion of patients with a past-year MDE who reported SI increased from 26.2% (668,690 of 2,550,641) to 32.5% (1,068,504 of 3,285,986; OR, 1.38; 95% CI, 1.25 to 1.51) and remained significant in the multivariable-adjusted analysis (P<.001). The greatest increase in SI was seen among Hispanic patients, young adults, and individuals with alcohol use disorder. Similar trends were seen for past-year SAs, increasing from 2.7% (69,548 of 2,550,641) to 3.3% (108,135 of 3,285,986; OR, 1.29; 95% CI, 1.04 to 1.61), especially among Black individuals, patients with incomes greater than $75,000, and those with substance use disorders. In multivariable-adjusted analyses, the temporal trend of increasing SI and SAs remained significant (P<.001 and P=0.04, respectively). Among individuals with past-year SI or SAs, there was no notable change in the mental health service use, and over 50% of individuals with MDE and SI (2,472,401 of 4,861,298) reported unmet treatment needs. No notable differences were observed between 2019 and 2020, reflecting the coronavirus disease 2019 pandemic. CONCLUSION Among individuals with MDE, rates of SI and SAs have increased, especially among racial minorities and individuals with substance use disorders, without a corresponding change in mental health service use.
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Affiliation(s)
| | - Robert A Rosenheck
- New England Mental Illness, Research Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT
| | - Taeho Greg Rhee
- New England Mental Illness, Research Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT.
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Kleiman EM, Glenn CR, Liu RT. The use of advanced technology and statistical methods to predict and prevent suicide. NATURE REVIEWS PSYCHOLOGY 2023; 2:347-359. [PMID: 37588775 PMCID: PMC10426769 DOI: 10.1038/s44159-023-00175-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 08/18/2023]
Abstract
In the past decade, two themes have emerged across suicide research. First, according to meta-analyses, the ability to predict and prevent suicidal thoughts and behaviours is weaker than would be expected for the size of the field. Second, review and commentary papers propose that technological and statistical methods (such as smartphones, wearables, digital phenotyping and machine learning) might become solutions to this problem. In this Review, we aim to strike a balance between the pessimistic picture presented by these meta-analyses and the optimistic picture presented by review and commentary papers about the promise of advanced technological and statistical methods to improve the ability to understand, predict and prevent suicide. We divide our discussion into two broad categories. First, we discuss the research aimed at assessment, with the goal of better understanding or more accurately predicting suicidal thoughts and behaviours. Second, we discuss the literature that focuses on prevention of suicidal thoughts and behaviours. Ecological momentary assessment, wearables and other technological and statistical advances hold great promise for predicting and preventing suicide, but there is much yet to do.
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Affiliation(s)
- Evan M. Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | | | - Richard T. Liu
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Gonda X, Dome P, Serafini G, Pompili M. How to save a life: From neurobiological underpinnings to psychopharmacotherapies in the prevention of suicide. Pharmacol Ther 2023; 244:108390. [PMID: 36940791 DOI: 10.1016/j.pharmthera.2023.108390] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
The impact of suicide on our societies, mental healthcare, and public health is beyond questionable. Every year approximately 700 000 lives are lost due to suicide around the world (WHO, 2021); more people die by suicide than by homicide and war. Although suicide is a key issue and reducing suicide mortality is a global imperative, suicide is a highly complex biopsychosocial phenomenon, and in spite of several suicidal models developed in recent years and a high number of suicide risk factors identified, we still have neither a sufficient understanding of underpinnings of suicide nor adequate management strategies to reduce its prevalence. The present paper first overviews the background of suicidal behavior including its epidemiology, prevalence, age and gender correlations and its association with neuropsychiatric disorders as well as its clinical assessment. Then we give an overview of the etiological background, including its biopsychosocial contexts, genetics and neurobiology. Based on the above, we then provide a critical overview of the currently available intervention options to manage and reduce risk of suicide, including psychotherapeutic modalities, traditional medication classes also providing an up-to-date overview on the antisuicidal effects of lithium, as well as novel molecules such as esketamine and emerging medications and further molecules in development. Finally we give a critical overview on our current knowledge on using neuromodulatory and biological therapies, such as ECT, rTMS, tDCS and other options.
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Affiliation(s)
- Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Risk of suicide attempt repetition after an index attempt: A systematic review and meta-analysis. Gen Hosp Psychiatry 2023; 81:51-56. [PMID: 36805332 DOI: 10.1016/j.genhosppsych.2023.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition. METHODS This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022. RESULTS A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01. CONCLUSION One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives.
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Bandara P, Page A, Hammond TE, Sperandei S, Stevens GJ, Gunja N, Anand M, Jones A, Carter G. Surveillance of Hospital-Presenting Intentional Self-Harm in Western Sydney, Australia, During the Implementation of a New Self-Harm Reporting Field. CRISIS 2023; 44:135-145. [PMID: 35138153 DOI: 10.1027/0227-5910/a000845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Hospital-presenting self-harm is a strong predictor of suicide and has substantial human and health service costs. Aims: We aimed to identify changes in case ascertainment after implementation of a new self-harm reporting field at a tertiary hospital in New South Wales, and to report event rates, demographic, and clinical characteristics. Method: Self-harm events presenting to the emergency department (October 2017 to August 2020) were identified using clinical documentation and a new reporting field. Changes in the frequency of self-harm in the period after implementation of the self-harm field were assessed through Poisson regression models. Results: A twofold increase in the frequency of self-harm was detected following the implementation of the new reporting field. The annual average age-standardized event rate of self-harm was 110.4 per 100,000 (120.8 per 100,000 for females; 100.1 per 100,000 for males). The highest rates by age and sex were for females aged 15-19 years (375 per 100,000) and males aged 20-24 years (175 per 100,000). Limitations: Self-harm identification relies on clinician coding practice, which is subject to variability and potential under-enumeration. Conclusion: These findings highlight the value of a self-harm reporting field in hospital record systems for accurate recording and long-term monitoring of self-harm event rates.
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Affiliation(s)
- Piumee Bandara
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Trent Ernest Hammond
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Sandro Sperandei
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Garry John Stevens
- School of Social Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Naren Gunja
- Department of Clinical Pharmacology and Toxicology, Western Sydney Health, Wentworthville, NSW, Australia
- Digital Health Solutions, Cumberland Hospital, Western Sydney Health, Wentworthville, NSW, Australia
- Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Manish Anand
- Consultation Liaison Psychiatry, Westmead Hospital, Westmead, NSW, Australia
| | - Alison Jones
- Department of Clinical Pharmacology and Toxicology, Western Sydney Health, Wentworthville, NSW, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Greg Carter
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
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Turner BJ, Switzer AC, Welch BE, Legg NK, Gregory MA, Phiri P, Rathod S, Paterson TSE. Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada. J Affect Disord 2023; 324:566-575. [PMID: 36584705 PMCID: PMC9794401 DOI: 10.1016/j.jad.2022.12.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The COVID-19 pandemic's mental health impact is well-established. While early evidence suggested suicide deaths remained stable or declined, suicidal ideation (SI) became more prevalent than before the pandemic. Our study: (1) examined the prevalence and distribution of SI among Canadian adults, (2) compared SI among those with and without pre-existing mental illnesses, and (3) evaluated associations between pandemic-related stressors (i.e., unemployment, insecure employment, loss of income, medical vulnerability, COVID-19 exposure) with SI, and whether such associations were mediated by depression, thwarted belongingness, perceived burdensomeness, or perceived discrimination. METHODS The sample was comprised of data gathered at three timepoints (Wave 1 08/18/2020-10/01/2020, n = 6629; Wave 2 12/21/2020-03/31/2021, n = 5920; Wave 3 09/07/2021-12/07/2021, n = 7354). Quota-based responses from survey research panels which matched the geographic, age, and sex distribution of the Canadian population were supplemented with convenience-sampled responses. RESULTS The prevalence of SI was 4.1 % (Wave 1), 5.3 % (Wave 2), and 5.8 % (Wave 3). Odds of SI were higher for respondents under the age of 35 years and with pre-existing mental illnesses. SI was associated with quarantining due to suspected or confirmed COVID-19 exposure, potential COVID-19 exposure at work, medical vulnerability toward COVID-19, insecure employment or unemployment, and income loss. These associations were mediated by psychological experiences, particularly depression and thwarted belongingness. LIMITATIONS This cross-sectional, observational study cannot establish temporality or causality. CONCLUSION Results highlight groups who may benefit from enhanced screening for depression and suicide risk. Reducing depression and increasing sense of belonging should be prioritized.
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Affiliation(s)
- Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, BC, Canada.
| | - Andrew C Switzer
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Brooke E Welch
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Nicole K Legg
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | - Peter Phiri
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK; School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Shanaya Rathod
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK; Faculty of Science, University of Portsmouth, UK
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Zhang N, Sandler I, Tein JY, Wolchik S. Reducing suicide risk in parentally bereaved youth through promoting effective parenting: testing a developmental cascade model. Dev Psychopathol 2023; 35:433-446. [PMID: 34872628 PMCID: PMC9170840 DOI: 10.1017/s0954579421001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who experience parental death are at increased risk for suicide. The Family Bereavement Program (FBP) is an upstream preventive intervention for parentally bereaved families that was found to reduce suicide risk in parentally bereaved youth up to 6 and 15 years later. We tested whether FBP-induced improvements in effective parenting led to changes in multiple proximal factors that prior theory and research implicated in the cascading pathway to suicide risk, namely, aversive self-views, caregiver connectedness, peer connectedness, complicated grief, depressive symptoms, and emotion suppression. The sample was 244 bereaved youth and their surviving caregiver from 156 families. Families were randomized into the FBP (12 group-based sessions for parents, youth, and two joint sessions) or a literature control condition. Multimethod and multiinformant data were collected at baseline, posttest, 6-year and 15-year follow-up assessments. Results showed that program-induced improvements in effective parenting at posttest were associated with reduced aversive self-views and increased caregiver connectedness at the 6-year follow-up, and each mediator was in turn associated with reduced suicide risk at the 6- and 15-year follow-up. The mediated pathways via aversive self-views remained significant while controlling for caregiver connectedness. Self-related concepts may be important targets in upstream suicide prevention for at-risk youth.
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Affiliation(s)
- Na Zhang
- Department of Human Development and Family Sciences, University of Connecticut, Stamford, CT, USA
| | - Irwin Sandler
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jenn-Yun Tein
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sharlene Wolchik
- REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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Walsh EH, Herring MP, McMahon J. A Systematic Review of School-Based Suicide Prevention Interventions for Adolescents, and Intervention and Contextual Factors in Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:365-381. [PMID: 36301381 DOI: 10.1007/s11121-022-01449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/26/2022]
Abstract
Suicide is the fourth leading cause of death among adolescents, globally. Though post-primary, school-based suicide prevention (PSSP) has the potential to be a key strategy for preventing adolescent suicidal thoughts and behaviours (STBs), there are persisting challenges to translating PSSP research to practice. Intervention and contextual factors relevant to PSSP are likely key to both PSSP effectiveness and implementation. As such, this systematic review aimed to summarise the effectiveness of PSSP for adolescent STBs and highlight important intervention and contextual factors with respect to PSSP. PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials were searched to identify randomised and non-randomised studies evaluating the effectiveness of interventions located in post-primary, school-based settings targeting adolescent STBs. PSSP effectiveness and intervention and contextual factors were synthesised narratively. Twenty-eight studies were retained, containing nearly 47,000 participants. Twelve out of twenty-nine trials comparing intervention and independent control comparators reported statistically significant reductions in STBs postintervention, and 5/7 trials comparing preintervention and postintervention scores demonstrated significant reductions in STBs over time. Reporting and analysis of intervention and contextual factors were lacking across studies, but PSSP effectiveness and intervention acceptability varied across type of school. Although school personnel commonly delivered PSSP interventions, their input and perspectives on PSSP interventions were lacking. Notably, adolescents had little involvement in designing, inputting on, delivering and sharing their perspectives on PSSP interventions. Twenty out of twenty-eight studies were rated as moderate/high risk of bias, with non-randomised trials demonstrating greater risks of bias and trial effectiveness, in comparison to cluster randomised trials. Future research should prioritise complete reporting and analysis of intervention and contextual factors with respect to PSSP, involving key stakeholders (including adolescents and school personnel) in PSSP, and investigating key stakeholders' perspectives on PSSP. Given the inverse associations between both study quality and study design with PSSP effectiveness, particular consideration to study quality and design in PSSP research is needed. Future practice should consider PSSP interventions with universal components and PSSP which supports and involves key stakeholders in engaging with PSSP.
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Affiliation(s)
- Eibhlin H Walsh
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland.
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Matthew P Herring
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Jennifer McMahon
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Carter G, Sperandei S, Spittal MJ, Chitty K, Clapperton A, Page A. Characteristics of suicide decedents with no federally funded mental health service contact in the 12 months before death in a population-based sample of Australians 45 years of age and over. Suicide Life Threat Behav 2023; 53:110-123. [PMID: 36353997 PMCID: PMC10947544 DOI: 10.1111/sltb.12928] [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: 11/25/2021] [Revised: 08/12/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION More than half of suicide decedents have no contact with mental health services 12 months before death. It is uncertain if they have different characteristics than decedents who use mental health services. METHODS A case-series design. Participants 45 years and older, who died by suicide (2006-2018). Comparisons were made between those who did and did not have contact with mental health services, using individually linked data from federal services in the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). RESULTS Of 186 cases, 71% had no contact with mental health services. Physical health services were used equally by 75%. Psychiatric medication use was uncommon, except for antidepressants, 50% with mental health service contact and 20% with no contact. Older age, lower income, involuntarily unemployed, firearms as suicide method, greater physical disability, less functional impairment due to emotional problems and lesser proportions with mental illness, were associated with no contact with mental health services. CONCLUSIONS For suicide prevention, middle-older aged adults may have less requirement for mental health intervention, and greater requirement for the development of complementary interventions focused on physical health and social issues, which are not necessarily best delivered by clinical mental health services.
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Affiliation(s)
- Gregory Carter
- Faculty of Medicine and Health ScienceUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Sandro Sperandei
- Translational Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Matthew J. Spittal
- Melbourne School of Population and Global HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Kate Chitty
- School of Medical Sciences, Discipline of Biomedical Informatics and Digital HealthThe University of SydneySydneyNew South WalesAustralia
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Angela Clapperton
- Melbourne School of Population and Global HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Andrew Page
- Translational Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
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Denche-Zamorano Á, Pereira-Payo D, Franco-García JM, Pastor-Cisneros R, Salazar-Sepúlveda G, Castillo D, Marín-Gil M, Barrios-Fernandez S. Mapping the Scientific Research on Suicide and Physical Activity: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16413. [PMID: 36554291 PMCID: PMC9778543 DOI: 10.3390/ijerph192416413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
This research provides an overview of the current state of scientific literature related to suicide and physical activity (PA). A bibliometric analysis of studies published between 1996 and 2022 in The Web of Science (WoS) was carried out, applying the traditional bibliometric laws, using Microsoft Excel and the VOSviewer software for data and metadata processing. A total of 368 documents (349 primary research and 19 reviews) were extracted from 70 WoS categories. The results revealed an exponential increase in scientific production from 2017 to 2022 (R2 = 88%), revealing the United States hegemony being the most productive country, with 156 of the publications (42.4%), the most cited (4181 citations) being the centre of a collaborative network with links to 35 countries and having April Smith, from the Miami University, as the most prolific author (eight publications) and Thomas Joiner, from the Florida State University, as the most cited author (513 citations). The Psychiatry WoS category, with 155 papers, had the highest number of publications, and The Journal of Affective Disorders, from Elsevier, had the highest number of published papers within this category.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Damián Pereira-Payo
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Juan Manuel Franco-García
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Guido Salazar-Sepúlveda
- Departamento de Ingeniería Industrial, Facultad de Ingeniería, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
- Facultad de Ingeniería y Negocios, Universidad de Las Américas, Concepción 4090940, Chile
| | - Dante Castillo
- Centro de Estudios e Investigación Enzo Faletto, Universidad de Santiago de Chile, Santiago 9170022, Chile
| | - Miseldra Marín-Gil
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
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Pham TV, Fetter AK, Wiglesworth A, Rey LF, Prairie Chicken ML, Azarani M, Riegelman A, Gone JP. Suicide interventions for American Indian and Alaska Native populations: A systematic review of prevention strategies, logics, and rationales. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Favril L, Yu R, Uyar A, Sharpe M, Fazel S. Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies. EVIDENCE-BASED MENTAL HEALTH 2022; 25:148-155. [PMID: 36162975 PMCID: PMC9685708 DOI: 10.1136/ebmental-2022-300549] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
QUESTION Effective prevention of suicide requires a comprehensive understanding of risk factors. STUDY SELECTION AND ANALYSIS Five databases were systematically searched to identify psychological autopsy studies (published up to February 2022) that reported on risk factors for suicide mortality among adults in the general population. Effect sizes were pooled as odds ratios (ORs) using random-effects models for each risk factor examined in at least three independent samples. FINDINGS A total of 37 case-control studies from 23 countries were included, providing data on 40 risk factors in 5633 cases and 7101 controls. The magnitude of effect sizes varied substantially both between and within risk factor domains. Clinical factors had the strongest associations with suicide, including any mental disorder (OR=13.1, 95% CI 9.9 to 17.4) and a history of self-harm (OR=10.1, 95% CI 6.6 to 15.6). By comparison, effect sizes were smaller for other domains relating to sociodemographic status, family history, and adverse life events (OR range 2-5). CONCLUSIONS A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength. PROSPERO REGISTRATION NUMBER CRD42021232878.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Abdo Uyar
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Michael Sharpe
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Wand AP, Browne R, Jessop T, Peisah C. A systematic review of evidence-based aftercare for older adults following self-harm. Aust N Z J Psychiatry 2022; 56:1398-1420. [PMID: 35021912 DOI: 10.1177/00048674211067165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. METHODS Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. RESULTS Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. CONCLUSION Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.
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Affiliation(s)
- Anne Pf Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Older Peoples Mental Health Service, Jara Ward, Concord Centre for Mental Health, Sydney Local Health District, Concord, Australia
| | - Roisin Browne
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,ForeFront Motor Neuron Disease & Frontotemporal Dementia Clinic, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Tiffany Jessop
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Carmelle Peisah
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
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The effectiveness of an Australian community suicide prevention networks program in preventing suicide: a controlled longitudinal study. BMC Public Health 2022; 22:1945. [PMID: 36261796 PMCID: PMC9583518 DOI: 10.1186/s12889-022-14331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Suicide is a major issue affecting communities around the world. Community-based suicide prevention approaches can tailor activities at a local level and are recognised as a key component of national suicide prevention strategies. Despite this, research exploring their effects on completed suicides is rare. This study examined the effect of a national program of community suicide prevention networks on suicide rates in catchment areas across Australia. Methods Australian suicide data from the National Coronial Information System for 2001–2017 were mapped to geographic catchment areas of community suicide prevention networks and matched control areas with similar characteristics. The effect of network establishment on suicide rates was evaluated using longitudinal models including fixed effects for site type (network or control), time, season, and intervention (network establishment), with site included as a random intercept. Results Sixty suicide prevention networks were included, servicing areas with a population of 3.5 million. Networks varied in when they were established, ranging from 2007 to 2016. Across the time-period, suicide rates per 100,000 per quarter averaged 3.73 (SD = 5.35). A significant reduction in the suicide rate of 7.0% was found after establishment of networks (IRR = 0.93, 95% CI 0.87 to 0.99, p = .025). Conclusion This study found evidence of an average reduction in suicide rates following the establishment of suicide prevention networks in Australian communities. These findings support the effectiveness of empowering local communities to take action to prevent suicide.
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Lopez-Castroman J, Jaussent I, Pastre M, Baeza-Velasco C, Kahn JP, Leboyer M, Diaz E, Courtet P. Severity features of suicide attempters with epilepsy. J Psychiatr Res 2022; 154:44-49. [PMID: 35926425 DOI: 10.1016/j.jpsychires.2022.07.030] [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: 05/05/2022] [Revised: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND After the Food and Drug Administration alert about antiepileptic medication and suicide, incident epilepsy has been associated with first or recurrent suicide attempts independently of psychiatric comorbidities and antiepileptic treatment. Following this thread, the aim of this study was to analyze if epilepsy was associated with a higher severity of lifetime suicide attempts (SAs). METHODS Analyses were carried out on 1677 adults hospitalized between 1999 and 2012 after a SA in a specialized ward for affective episodes. Five severity features were studied: frequent SAs (>2), early onset of first SA (≤26 years), history of violent SA, high suicide intent and high lethality of the SA. Adjusted logistic regression models were used to estimate the association between the lifetime diagnosis of epilepsy and the severity features. RESULTS Among suicide attempters, ninety-three patients reported a lifetime diagnosis of epilepsy (5.5%). Epileptic patients diagnosed after the first SA were more likely to be frequent suicide attempters than non-epileptic ones. They showed also higher SA planification scores. LIMITATIONS Diagnosis accuracy is limited by the use of self-reports for epilepsy. The lack of precise information about the disease course and treatment have not allowed for further statistical analysis. With regard to psychiatric comorbidities, personality disorders could not be taken into account. CONCLUSIONS Suicide attempters with epilepsy present an increased severity in some aspects of their suicidal behavior regardless of demographic and clinical variables. Our results give support to the existence of a bidirectional association between epilepsy and suicidal behavior.
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Affiliation(s)
- Jorge Lopez-Castroman
- Department of Psychiatry, CHU Nimes, Nimes, France; IGF, Université de Montpellier, CNRS-INSERM, Montpellier, France.
| | | | | | - Carolina Baeza-Velasco
- IGF, Université de Montpellier, CNRS-INSERM, Montpellier, France; Department of Emergency Psychiatry and Post-acute Care, CHU Montpellier, Montpellier, France; Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100, Boulogne Billancourt, France
| | - Jean-Pierre Kahn
- Université de Lorraine, Nancy, France, Clinique Soins-Etudes de Vitry le François, Fondation Santé des Etudiants de France (FSEF), Paris, France
| | - Marion Leboyer
- INSERM U955, Neuro-Psychiatrie Translationnelle, Université Paris-Est, Créteil, France; AP-HP, DMU IMPACT, Département Médical Universitaire de Psychiatrie, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | | | - Philippe Courtet
- IGF, Université de Montpellier, CNRS-INSERM, Montpellier, France; Department of Emergency Psychiatry and Post-acute Care, CHU Montpellier, Montpellier, France
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Swed S, Rais MA, Aljabali A, Siddiq A, Elsayed M, Shoib S. Suicide prevention in Syria. Lancet Psychiatry 2022; 9:e47. [PMID: 36116451 DOI: 10.1016/s2215-0366(22)00299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Sarya Swed
- Faculty of Medicine Aleppo University, Aleppo 22743, Syria.
| | | | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
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McGill K, Salem A, Hanstock TL, Heard TR, Garvey L, Leckning B, Whyte I, Page A, Carter G. Indigeneity and Likelihood of Discharge to Psychiatric Hospital in an Australian Deliberate Self-Poisoning Hospital-Treated Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12238. [PMID: 36231541 PMCID: PMC9566708 DOI: 10.3390/ijerph191912238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Hospital-treated self-harm rates for Aboriginal and Torres Strait Islander (Indigenous) people are at least double those for other Australians. Despite this, limited research has explored the relationship between Indigeneity and the clinical management of hospital-treated deliberate self-harm. A retrospective clinical cohort study (2003-2012) at a regional referral centre (NSW) for deliberate self-poisoning was used to explore the magnitude and direction of the relationship between Indigeneity and discharge destination (psychiatric hospital vs. other) using a series of logistic regressions. There were 149 (4%) Indigenous and 3697 (96%) non-Indigenous deliberate self-poisoning admissions during the study period. One-third (31%) were referred to the psychiatric hospital at discharge; Indigenous 21% (n = 32) vs. non-Indigenous 32% (n = 1175). Those who identified as Indigenous were less likely to be discharged to the psychiatric hospital, OR 0.59 (0.40-0.87) at the univariate level, with little change after sequential adjustment; and AOR 0.34 (0.21-0.73) in the fully adjusted model. The Indigenous cohort had a lower likelihood of psychiatric hospital discharge even after adjustment for variables associated with discharge to the psychiatric hospital highlighting the need for further investigation of the reasons accounting for this differential pattern of clinical management and the effectiveness of differential after-care allocation.
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Affiliation(s)
- Katie McGill
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Healthy Minds, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
- Mental Health-Research, Evaluation and Dissemination (MH-READ), Hunter New England Local Health District, Newcastle, NSW 2298, Australia
| | - Amir Salem
- School of Psychological Sciences, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Tanya L. Hanstock
- School of Psychological Sciences, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Todd R. Heard
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Healthy Minds, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
- Wiyillin Ta Child and Adolescent Mental Health Service, Hunter New England Local Health District, Newcastle, NSW 2300, Australia
| | - Leonie Garvey
- Aboriginal Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Bernard Leckning
- Black Dog Institute, University of New South Wales, Sydney, NSW 1466, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia
| | - Ian Whyte
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Calvary Mater Newcastle, Newcastle, NSW 2298, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Greg Carter
- Healthy Minds, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
- Calvary Mater Newcastle, Newcastle, NSW 2298, Australia
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