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Babajani F, Salari N, Hosseinian-Far A, Abdoli N, Mosafer H, Heidarian P, Mohammadi M. Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis. Asian J Psychiatr 2024; 91:103878. [PMID: 38142521 DOI: 10.1016/j.ajp.2023.103878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Over 700,000 people worldwide lose their lives through suicide every year. The prevalence of suicide has increased, especially in low- and middle-income countries such as many African countries. For every fatal suicidal attempt, there are approximately 20 other non-fatal suicide attempts within the population. The purpose of this study is to investigate the prevalence of attempts of suicides in the African continent through a systematic review and meta-analysis. METHODS To identify relevant sources, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories and databases were systematically searched without a lower time limit and until July 2023. The heterogeneity of the studies was checked with the I2 index, and accordingly random effects model was adopted to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v.2). RESULTS In the review of 48 studies with a sample size of 244,701 people, the prevalence of suicide attempts in Africa was found to be 9.9% (95%CI: 8.5%-11.6%). With the increase in the year of study, the prevalence of suicide attempt in the African continent increases. Also, with the increase in the sample size, the prevalence of suicide attempts in Africa decreases. The suicide attempt prevalence among African men and woman slightly differed with 7.6% and 8.2%, respectively. CONCLUSION Suicide attempt is an important public health concern in Africa. The findings of this study are important not only for African health policy making, but also to contribute to the accuracy of global estimates with respect to suicide attempts.
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Affiliation(s)
- Fateme Babajani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems & Operations, University of Northampton, Northampton, UK
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadis Mosafer
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Heidarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Barrimi M, Serraj K, Rammouz I, Alouane R, Messaoudi N, Bellaoui M. Prevalence of and Risk Factors for Suicide Attempts Among Patients With Severe Psychiatric Disorders in Eastern Morocco. CRISIS 2023; 44:21-28. [PMID: 34674543 DOI: 10.1027/0227-5910/a000825] [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: Suicide attempts are common in patients with severe psychiatric disorders; however, they are rarely studied in this population. Aims: To investigate the prevalence and risk factors associated with suicide attempts among patients with severe psychiatric disorders. Method: This is a cross-sectional study of patients admitted to the Mohammed VI University Hospital of Psychiatry in Oujda, Morocco. Results: A total of 250 patients with a psychiatric disorder were recruited in this study. Among these, 78 cases (31.2%) had a personal history of suicide attempts. A personal history of suicide attempt was significantly higher among women compared to men (45.5% vs. 27.2%, p = .0099). The most common method of suicide attempts was jumping from heights (31%). Patients with a personal history of suicide attempts had a significantly higher prevalence of alcohol consumption (p = .0063), family history of psychiatric disorders (p = .002), family history of suicide attempt (p = .00004), and family history of suicide (p = .018) compared to those who had never made suicide attempts. Limitations: As suicidal behavior is highly stigmatized in Morocco, the number of patients who have made a suicide attempt may be underestimated. Conclusion: Our findings justify the need to provide specialized support to psychiatric patients with risk factors for suicide attempts.
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Affiliation(s)
- Mohammed Barrimi
- Department of Psychiatry, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Khalid Serraj
- Department of Internal Medicine, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Ismail Rammouz
- Department of Psychiatry, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Rachid Alouane
- Department of Psychiatry, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Najoua Messaoudi
- Department of Psychiatry, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
| | - Mohammed Bellaoui
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco
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Crocker LD, Jurick SM, Merritt VC, Keller AV, Hoffman SN, Davey DK, Jak AJ. Mechanisms through which executive dysfunction influences suicidal ideation in combat-exposed Iraq and Afghanistan veterans. Clin Neuropsychol 2022; 36:2073-2092. [PMID: 34524071 DOI: 10.1080/13854046.2021.1974566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Executive dysfunction has previously been associated with suicidality, but it remains unclear how deficits in executive functioning contribute to increased suicidal thoughts and behaviors. Although it has been proposed that poorer executive functioning leads to difficulty generating and implementing appropriate coping strategies to regulate distress and inhibit suicidal thoughts and behaviors, studies have not systematically examined these relationships. Therefore, the present study examined various hypotheses to elucidate the mechanisms through which executive dysfunction influences suicidal ideation (SI) in combat-exposed Iraq/Afghanistan veterans. METHOD Veterans who endorsed SI were compared to those who denied SI on demographic and diagnostic variables and measures of neuropsychological functioning, psychological symptoms, coping styles, and combat experiences. Serial mediation models were tested to examine mechanistic relationships among executive functioning, psychological distress, coping, and SI. RESULTS Those who endorsed SI had worse executive functioning, greater psychological distress, and greater avoidant coping relative to those who denied SI. Serial mediation model testing indicated a significant indirect path, such that executive dysfunction increased psychological distress, which in turn increased avoidant coping, leading to SI. CONCLUSIONS Findings support and extend previous hypotheses regarding how executive functioning contributes to increased risk of suicidality via increased distress and avoidant coping. Intervention efforts focused on reducing suicidality may benefit from techniques that enhance executive functioning (e.g. computerized training, cognitive rehabilitation) and in turn reduce distress prior to targeting coping strategies.
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Affiliation(s)
- Laura D Crocker
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sarah M Jurick
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Amber V Keller
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Samantha N Hoffman
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Delaney K Davey
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Amy J Jak
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
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Kassie GM, Lemu YM, Biresaw MS, Dessie GM, Tadesse GT, Gared WM, Belay MW. Suicidal ideation and attempt and associated factors among patients with substance use disorder: institution-based cross-sectional study. BJPsych Open 2022; 8:e150. [PMID: 35912979 PMCID: PMC9380183 DOI: 10.1192/bjo.2022.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND No published research in Ethiopia has examined the prevalence of suicidal ideation and suicide attempts and associated factors among patients with substance use disorder. AIMS The main aim of this study was to assess the prevalence of suicidal ideation, suicide attempt and associated factors among patients with substance use disorders. METHOD An institution-based cross-sectional study was conducted from 5 May to 13 June 2019 in Addis Ababa. A total of 408 patients were identified using a systematic sampling technique. Data were collected through interviews using the suicidality module of the Composite International Diagnostic Interview. Data were entered into EpiData and analysed using SPSS. Logistic regression analyses were employed. Variables with P < 0.05 were considered to be statistically significant with 95% confidence intervals. RESULTS Prevalence rates of suicidal ideation and attempt were found to be 39.5% and 18.6%, respectively. Family history of mental illness (adjusted odds ratio (AOR) = 3.60, 95% CI: 2.17, 5.97), comorbid mental illness (AOR = 3.61, 95% CI: 2.11, 6.16), perceived stigma related to substance misuse (AOR = 4.00, 95% CI: 2.26, 7.07) and alcohol use (AOR = 7.49, 95% CI: 1.99, 28.19) were associated with suicidal ideation. Being female (AOR = 2.46, 95% CI: 1.08, 5.70), family history of suicide (AOR = 3.08, 95% CI: 1.68, 5.64), comorbid mental illness (AOR = 4.09, 95% CI: 2.23, 7.49) and khat use (AOR = 3.73, 95% CI: 1.24, 11.17) were associated with suicide attempt. CONCLUSIONS The prevalence of suicidal ideation and attempt were both found to be high. In particular, patients who had a comorbid mental illness were at high risk of both suicidal ideation and attempt. Therefore, special attention should be given to those with a family history of suicide or comorbid mental illness.
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Affiliation(s)
- Gebeyaw Molla Kassie
- Department of Psychiatry, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Yohanes Mirekena Lemu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu Biresaw
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | | | - Woredaw Minichil Gared
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mesele Wonde Belay
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Abderrahmane A, Kharbach A, Azzine H, Lkoul A, Bouchriti Y, Cherrat Z, Ezzahir N, Boukrim M, Sine H. [Tentatives de suicide au Maroc: une revue systématique]. Rev Epidemiol Sante Publique 2022; 70:243-251. [PMID: 35927118 DOI: 10.1016/j.respe.2022.05.006] [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: 01/13/2022] [Revised: 05/07/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Suicide is a widespread phenomenon that affects persons of all ages, and it has become a major public health problem in Morocco. OBJECTIVES This study aims to describe the epidemiological profile of suicide attempters in Morocco, as well as the identification of associated factors. METHODS The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis (2009)", including articles dealing with suicide attempts in Morocco that meet the usual inclusion criteria. The PubMed, ScienceDirect and Scopus databases were searched; articles had to be written in English or French. Additional studies were manually identified through via Google Scholar. Quality assessment of the included studies was carried out according to the NIH Assessment Tool. The review protocol was registered in PROSPERO (CRD42020165493). RESULTS Twenty studies were selected. Adults and adolescents are the age groups most affected by suicide. That said, the phenomenon mainly concerns children over 10 years of age. In some studies, more than 90% of the cases involve females, and they are more numerous in urban than in rural settings, and single individuals are more affected than married people. As for children and adolescents, most of them had divorced parents, and more than 50% of suicidal persons of all ages had a low socio-economic level. Although females are more likely than males to commit suicide, males are more exposed to death due to the violent means used. CONCLUSIONS Because of the alarming rate of suicide in our country, nationwide prevention strategies are called for.
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Affiliation(s)
- Achbani Abderrahmane
- Higher Institute of Nursing Professions and Health Techniques, Marrakech, Morocco; Laboratory of Cell Biology and Molecular Genetics, Department of Biology, Faculty of Sciences, University Ibn Zohr, Agadir, Morocco
| | - Ahmed Kharbach
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco; Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco.
| | - Hajar Azzine
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco
| | - Abdelmajid Lkoul
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco
| | - Youssef Bouchriti
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco; Applied Geosciences and Environment Team, Faculty of Agadir Sciences, IBN ZOHR University, Agadir, Morocco
| | - Zakariae Cherrat
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco; Laboratory of Community health, preventive medicine and hygiene, Department of public health, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Nadia Ezzahir
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco
| | - Mohamed Boukrim
- Higher Institute of Nursing Professions and Health Techniques, Marrakech, Morocco; Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco
| | - Hasnaa Sine
- Higher Institute of Nursing Professions and Health Techniques, Marrakech, Morocco; Medical Biology, Human and Experimental Pathology and Environment, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Davey DK, Jurick SM, Crocker LD, Hoffman SN, Sanderson-Cimino M, Tate DF, Velez CS, Delano-Wood L, Jak AJ. White matter integrity, suicidal ideation, and cognitive dysfunction in combat-exposed Iraq and Afghanistan Veterans. Psychiatry Res Neuroimaging 2021; 317:111389. [PMID: 34563989 DOI: 10.1016/j.pscychresns.2021.111389] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 11/26/2022]
Abstract
White matter alterations in frontolimbic circuits and poorer cognitive functioning have been observed in individuals endorsing suicidality across numerous psychiatric conditions. However, relationships between white matter integrity, cognition, and suicidality in Veterans are poorly understood, particularly for those at increased risk for suicide due to mental health conditions (e.g., posttraumatic stress disorder, depression) and traumatic brain injury history. We (1) examined white matter alterations in combat-exposed Iraq/Afghanistan Veterans with and without suicidal ideation (SI) and (2) investigated relationships between white matter integrity and neuropsychological functioning in regions that differed between SI groups. No group differences were found regarding psychiatric diagnoses. Participants with SI had lower fractional anisotropy (FA) in the posterior corona radiata, superior corona radiata, and superior longitudinal fasciculus relative to those without SI. Worse processing speed/attention performance was associated with lower FA in the superior longitudinal fasciculus, while worse executive functioning performance was associated with lower FA in the superior corona radiata and superior longitudinal fasciculus. Memory performance was not associated with FA. These findings suggest that white matter integrity may be involved in cognitive dysfunction and increased risk for SI. Interventions that target cognitive dysfunction may ameliorate SI, and in turn, reduce risk for suicide among Veterans.
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Affiliation(s)
- Delaney K Davey
- Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Sarah M Jurick
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States; Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Laura D Crocker
- Research Service, VA San Diego Healthcare System, San Diego, CA, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States
| | - Samantha N Hoffman
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Mark Sanderson-Cimino
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - David F Tate
- Department of Neurology, School of Medicine, University of Utah, Salt Lake City, UT, United States; George E. Wahlen VA Medical Center, Salt Lake City, UT, United States
| | - Carmen S Velez
- Department of Neurology, School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Lisa Delano-Wood
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States; Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Amy J Jak
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States; Psychology Service, VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States.
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Yoon S, Park K, Choi KH. The ultra brief checklist for suicidality. J Affect Disord 2020; 276:279-286. [PMID: 32697710 DOI: 10.1016/j.jad.2020.07.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/31/2020] [Accepted: 07/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Accurately identifying patients at an elevated risk of suicide in minimal time is an important mental health issue. Therefore, we developed the Ultra Brief Checklist for Suicidality (UBCS) and reported its psychometric properties. METHODS We studied 544 participants who had completed the UBCS, other self-report measures, and structured clinical interviews by trained interviewers. We explored the psychometric properties of the UBCS's paper-based and online versions by identifying optimal cutoff points, sensitivity, specificity, etc. of all participants. RESULTS The mean score of the UBCS (paper-pencil version) in the no-suicide-risk group was 0.23 (SD = 0.73), while in the Risk-Positive (RP) and the High-Risk (HR) groups it was 3.54 (SD = 3.22) and 6.31 (SD = 3.97), respectively. Optimal cutoff points for the RP and HR groups were 1 (AUC = 0.914) and 3 (AUC = 0.928), respectively. LIMITATIONS The current findings apply only to adults, not to children or adolescents. The original MINI was used as the assessment instrument's reference standard rather than MINI 7.0.2 of DSM-5. Predictive validity was not addressed as this was not a longitudinal cohort study. CONCLUSIONS The UBCS was rigorously tested and validated. More than half the participants completed the UBCS within a minute. It possesses adequate psychometric properties and can be easily administered with minimal clinician time and effort, via paper or Internet. We believe it can contribute to suicide risk identification and timely interventions.
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Affiliation(s)
- Seowon Yoon
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea
| | - Kiho Park
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea; KU Mind Health Institute, Korea University, Seoul, Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea; KU Mind Health Institute, Korea University, Seoul, Korea.
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Fekadu A, Medhin G, Selamu M, Shiferaw T, Hailemariam M, Rathod SD, Jordans M, Teferra S, Lund C, Breuer E, Prince M, Giorgis TW, Alem A, Hanlon C. Non-fatal suicidal behaviour in rural Ethiopia: a cross-sectional facility- and population-based study. BMC Psychiatry 2016; 16:75. [PMID: 27000122 PMCID: PMC4802839 DOI: 10.1186/s12888-016-0784-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/17/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Injury related to self-harm is one of the leading causes of global disease burden. As a formative work for a programme to implement comprehensive mental healthcare in a rural district in Ethiopia, we determined the 12-month prevalence of non-fatal suicidal behaviour as well as factors associated with this behaviour to understand the potential burden of the behaviour in the district. METHOD Population-based (n = 1485) and facility-based (n = 1014) cross-sectional surveys of adults, using standardised, interview-based measures for suicidality (items on suicide from the Composite International Diagnostic Interview), depressive symptoms (the Patient Health Questionnaire) and alcohol use disorders (Alcohol Use Disorder Investigation Test; AUDIT). RESULTS The overall 12-month prevalence of non-fatal suicidal behaviour, consisting of suicidal ideation, plan and attempt, was 7.9 % (95 % Confidence Interval (CI) = 6.8 % to 8.9 %). The prevalence was significantly higher in the facility sample (10.3 %) compared with the community sample (6.3 %). The 12-month prevalence of suicide attempt was 4.4 % (95 % CI = 3.6 % to 5.3 %), non-significantly higher among the facility sample (5.4 %) compared with the community sample (3.8 %). Over half of those with suicidal ideation (56.4 %) transitioned from suicidal ideation to suicide attempt. Younger age, harmful use of alcohol and higher depression scores were associated significantly with increased non-fatal suicidal behaviours. The only factor associated with transition from suicidal ideation to suicide attempt was high depression score. Only 10.5 % of the sample with suicidal ideation had received any treatment for their suicidal behaviour: 10.8 % of the community sample and 10.2 % of the facility sample. Although help seeking increased with progression from ideation to attempt, there was no statistically significant difference between the groups. CONCLUSION Non-fatal suicidal behaviour is an important public health problem in this rural district. A more in-depth understanding of the context of the occurrence of the behaviour, improving access to care and targeting depression and alcohol use disorder are important next steps. The role of other psychosocial factors should also be explored to assist the provision of holistic care.
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Affiliation(s)
- Abebaw Fekadu
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- />Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, UK
| | - Girmay Medhin
- />Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medhin Selamu
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsion Shiferaw
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Maji Hailemariam
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sujit D Rathod
- />Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jordans
- />Department of Research and Development, HealthNet Transcultural Psychosocial Organisation, Amsterdam, The Netherlands
| | - Solomon Teferra
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Crick Lund
- />Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - Erica Breuer
- />Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - Martin Prince
- />Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK
| | - Tedla W. Giorgis
- />Republic of Ethiopia Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Atalay Alem
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- />Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- />Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK
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Hakim Shooshtari M, Malakouti SK, Panaghi L, Mohseni S, Mansouri N, Rahimi Movaghar A. Factors Associated With Suicidal Attempts in Iran: A Systematic Review. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e948. [PMID: 27284284 PMCID: PMC4898752 DOI: 10.17795/ijpbs-948] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 02/28/2015] [Accepted: 10/10/2015] [Indexed: 11/29/2022]
Abstract
Context: Suicide prevention is a health service priority. Some surveys have assessed suicidal behaviors and potential risk factors. Objectives: The current paper aimed to gather information about etiology of suicide attempts in Iran. Data Sources: Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched. Study Selection: By electronic and gray literature search, 128 articles were enrolled in this paper. Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc were searched for electronic search. After reading the abstracts, 84 studies were excluded and full texts of 44 articles were reviewed critically. Data Extraction: Pubmed, ISI web of science, PsychInfo, IranPsych, IranMedex, IranDoc as well as gray literature were searched to find any study about etiologic factors of suicide attempt in Iran. Results: Depressive disorder was the most common diagnosis in suicide attempters that is 45% of the evaluated cases had depression. One study that had used Minnesota multiphasic personality inventory (MMPI) found that Histrionics in females and Schizophrenia and Paranoia in males were significantly influential. Family conflicts with 50.7% and conflict with parents with 44% were two effective psychosocial factors in suicidal attempts. In around one fourth (28.7%) of the cases, conflict with spouse was the main etiologic factor. Conclusions: According to the methodological limitations, outcomes should be generalized cautiously. Further studies will help to plan preventive strategies for suicidal attempts; therefore, continued researches should be conducted to fill the data gaps.
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Affiliation(s)
- Mitra Hakim Shooshtari
- Department of Psychiatry, Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Seyyed Kazem Malakouti
- Department of Psychiatry, Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Leili Panaghi
- Department of Psychology, Family Research Institute, Shahid Beheshti University, Tehran, IR Iran
| | - Shohreh Mohseni
- Department of Psychiatry, Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Naghmeh Mansouri
- Department of Psychiatry, Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Afarin Rahimi Movaghar
- Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, IR Iran
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Lee MA. Social relationships, depressive symptoms and suicidality in Korea: Examining mediating and moderating effects in men and women. Int J Soc Psychiatry 2016; 62:67-75. [PMID: 26148696 DOI: 10.1177/0020764015592434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It has been widely recognized that social relationships and depressive symptoms predict suicidality. However, there are few empirical studies examining relationships among these three factors using an integrative approach. AIMS This study aimed to examine the effects of perceived quality of social relationships and depressive symptoms on suicidality and to analyze whether the effect of perceived quality of social relationships on suicidality is mediated by depressive symptoms or whether the perceived quality of social relationships has a moderating effect on the relationship between depressive symptoms and suicidality in men and women. METHODS The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey. Multiple regression models and subsample analyses were conducted according to gender. RESULTS A higher perceived quality of social relationships decreased suicidality while depressive symptoms increased suicidality. The effect of perceived quality of social relationships was partially mediated by depressive symptoms. Perceived quality of social relationships also significantly interacted with depressive symptoms, suggesting that the harmful effect of depressive symptoms was ameliorated as perceived quality of social relationships increased. A subsample analysis according to gender, however, indicated a significant gender difference in that the perceived quality of social relationships moderated the effect of depressive symptoms only in women. CONCLUSION The findings suggest that enhanced quality of social relationships can protect people from suicidal risk and are more effective for women with depressive symptoms than for men with the same symptoms.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, Seoul, South Korea
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Zarrouq B, Bendaou B, Elkinany S, Rammouz I, Aalouane R, Lyoussi B, Khelafa S, Bout A, Berhili N, Hlal H, Nejjari C, El Rhazi K. Suicidal behaviors among Moroccan school students: prevalence and association with socio-demographic characteristics and psychoactive substances use: a cross-sectional study. BMC Psychiatry 2015; 15:284. [PMID: 26572129 PMCID: PMC4647598 DOI: 10.1186/s12888-015-0680-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/09/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Suicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students. METHODS From April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria. RESULTS A total of 3020 students (53 % boys) aged 11-23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively. Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents' divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use. CONCLUSIONS The intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents' suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.
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Affiliation(s)
- Btissame Zarrouq
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco. .,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco. .,Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdillah University, B.P 1893, Route Sidi Harazem, Km 2.2, Fez, Morocco.
| | - B. Bendaou
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco ,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - S. Elkinany
- Department of English, Dhar El Mahraz Faculty of literature and human sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - I. Rammouz
- Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - R. Aalouane
- Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - B. Lyoussi
- Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - S. Khelafa
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - A. Bout
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - N. Berhili
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - H. Hlal
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - C. Nejjari
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - K. El Rhazi
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
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Kim HK, Kim JY, Kim JH, Hyoung HK. Decision Tree Identified Risk Groups with High Suicidal Ideation in South Korea: A Population-Based Study. Public Health Nurs 2015. [DOI: 10.1111/phn.12219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hyun Kyung Kim
- College of Nursing; Chonbuk Research Institute of Nursing Science; Chonbuk National University; Jeonju-si Korea
| | - Ji Young Kim
- College of Nursing; Chonbuk Research Institute of Nursing Science; Chonbuk National University; Jeonju-si Korea
| | - Jong Hyen Kim
- Anti-Corruption & Civil Rights Commission; Sejong Korea
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Sadeghi S, Heydarheydari S, Darabi F, Golchinnia A. Suicide Attempts Among Patients Admited to Hospital of Kermanshah University of Medical Sciences. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2015; 4:e23028. [PMID: 26082910 PMCID: PMC4464502 DOI: 10.5812/ijhrba.23028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 11/17/2014] [Accepted: 01/01/2015] [Indexed: 11/19/2022]
Abstract
Background: Suicide is a modern-age human challenge considered as a social and mental health problem acquiring enormous attention on primary and secondary heath care plans. Objectives: The current study aimed to investigate frequency of suicide attempts and related social factors among patients admitted in Hospital of Kermanshah University of Medical Sciences Patients and Methods: This cross-sectional study was descriptive-analytical type carried out on 251 patients admitted at medical centers of Kermanshah University of Medical Sciences after failed suicide attempts. Data collection was done through filling forms. Results: Average age of the population was 29 ± 11.6 years. Female were more prone to commit suicide whereas the patients had a variety of social lifestyles and crisis such as divorce, drug abuse, and domestic problems. The most frequent method of committing suicide was the use of burning materials. Conclusions: In reference to the young age of the statistical population of attempters and frequent personal-life crisis among them, educational, welfare and consultation facilities are suggested.
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Affiliation(s)
- Shokouh Sadeghi
- Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
- Corresponding author: Shokouh Sadeghi, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-8338261084, E-mail:
| | - Sahel Heydarheydari
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Fatemeh Darabi
- Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Abdollah Golchinnia
- Cultural Affairs, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
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Lee MA. Emotional abuse in childhood and suicidality: The mediating roles of re-victimization and depressive symptoms in adulthood. CHILD ABUSE & NEGLECT 2015; 44:130-9. [PMID: 25890665 DOI: 10.1016/j.chiabu.2015.03.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 03/18/2015] [Accepted: 03/26/2015] [Indexed: 05/05/2023]
Abstract
This study examined the effects of emotional abuse in childhood, along with physical and sexual abuse, on suicidality in adulthood, and whether and how emotional abuse and depressive symptoms in adulthood mediate the association between the childhood emotional abuse and suicidality. The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey with a multistage area proportional probability sampling method. Random effects regression and the Sobel test were used to analyze the relationships between childhood emotional abuse and suicidality and the mediating effects. Random effects models showed that emotional abuse in childhood was positively associated with suicidality in adulthood, even after controlling for physical and sexual abuse in childhood. Emotional abuse and depressive symptoms in adulthood mediated the association between emotional abuse in childhood and suicidality. Depressive symptoms also mediated between emotional abuse in adulthood and suicidality. These findings suggest that emotional abuse in childhood has indirect harmful effects on suicidality in adulthood. It increases suicidality through higher occurrences of re-victimization and depressive symptoms in adulthood. Practitioners and policy makers should recognize that experiences of emotional abuse in childhood may result in re-victimization in adulthood, which, in turn, lead to suicidality. Early intervention programs to reduce the likelihood of experiencing re-victimization may be critical for people exposed to emotional abuse in childhood.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, 84 Heukseok-ro Dongjak-Gu, Seoul 156-756, Republic of Korea
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Abstract
Gambling Disorder is associated with elevated rates of suicidal thoughts and acts. However, virtually nothing is known about suicidality in people with subsyndromal forms of gambling disorder. A total of 174 non-treatment seeking subjects were recruited for a study of impulsivity and met criteria for a subsyndromal form of DSM-5 gambling disorder (31.0 % females; mean age = 21.7 ± 3.61 years). Subjects were categorized as being 'at risk of suicide' or 'no suicide risk' based on the Mini-International Neuropsychiatric Interview (MINI). Those with and without suicidality were compared on clinical and cognitive measures. 32 (18.4 %) met MINI criteria for suicidality. Suicidality was significantly associated with mood and anxiety disorders, greater rates of nicotine consumption, and relative impairments in decision-making and cognitive flexibility. These findings suggest that decision-making impairments may be implicated in the development of both gambling problems and suicidality. Future work should address causality, neural correlates, and tailored suicide prevention strategies for people with, or at risk for, disordered forms of gambling.
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Barrimi M, Zaidi K, Hlal H, Kettani N, Khelafa S, Rammouz I, Aalouane R. Tentatives de suicides violentes à l’hôpital général de Fès (Maroc) : évaluation et prise en charge en psychiatrie de liaison. Étude prospective sur six mois. EVOLUTION PSYCHIATRIQUE 2014. [DOI: 10.1016/j.evopsy.2013.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mars B, Burrows S, Hjelmeland H, Gunnell D. Suicidal behaviour across the African continent: a review of the literature. BMC Public Health 2014; 14:606. [PMID: 24927746 PMCID: PMC4067111 DOI: 10.1186/1471-2458-14-606] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 05/28/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world's second most populous continent, are limited. METHODS We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. RESULTS Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa's population; suicide attempt data were available for <20% of countries (7/53). Crude estimates suggest there are over 34,000 (inter-quartile range 13,141 to 63,757) suicides per year in Africa, with an overall incidence rate of 3.2 per 100,000 population. The recent Global Burden of Disease (GBD) estimate of 49,558 deaths is somewhat higher, but falls within the inter-quartile range of our estimate. Suicide rates in men are typically at least three times higher than in women. The most frequently used methods of suicide are hanging and pesticide poisoning. Reported risk factors are similar for suicide and suicide attempts and include interpersonal difficulties, mental and physical health problems, socioeconomic problems and drug and alcohol use/abuse. Qualitative studies are needed to identify additional culturally relevant risk factors and to understand how risk factors may be connected to suicidal behaviour in different socio-cultural contexts. CONCLUSIONS Our estimate is somewhat lower than GBD, but still clearly indicates suicidal behaviour is an important public health problem in Africa. More regional studies, in both urban and rural areas, are needed to more accurately estimate the burden of suicidal behaviour across the continent. Qualitative studies are required in addition to quantitative studies.
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Affiliation(s)
- Becky Mars
- School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom
| | - Stephanie Burrows
- Research Centre of the University of Montréal Hospital Centre, 3850 St-Urbain, H2W 1 T7 Montréal, Québec, Canada
- Department of Social and Preventive Medicine, University of Montréal, 7101 Avenue du Parc, H3N 1X7 Montréal, Québec, Canada
| | - Heidi Hjelmeland
- Department of Social Work and Health Science, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom
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Lee MA, Kim S, Shim EJ. Exposure to suicide and suicidality in Korea: differential effects across men and women? Int J Soc Psychiatry 2013; 59:224-31. [PMID: 22433241 DOI: 10.1177/0020764012441296] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little is known about whether exposure to suicide within close social networks is associated with the suicidality in exposed individuals, and potential gender differences regarding this association. AIMS This study examines the effect of exposure to suicide on the suicidality in exposed individuals. METHODS The data were drawn from the 2009 Korean General Social Survey, a nationally representative interview survey. Suicidality was measured by the suicidality module in the Mini International Neuropsychiatric Interview (MINI), with exposure to suicide being determined by asking about the experience of a failed or completed suicide attempt by a closely related person. RESULTS Exposure to the suicide of someone close was significantly associated with higher suicidality in exposed individuals. While the effect of a failed attempt became non-significant after controlling for psychological factors, that of exposure to a completed act of suicide remained significant. A subsample analysis by gender indicated a significant gender difference: with control for demographic and psychological factors, exposure to a completed suicide had a significant effect on the suicidality of females only. The effect of exposure to a failed attempt became non-significant both in males and females after controlling for other factors. CONCLUSIONS Findings suggest the necessity of screening for prior exposure to suicide in suicide risk assessment and the need for gender-tailored suicide-prevention strategies.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, Seoul, Korea
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Clinical and neurocognitive markers of suicidality in young adults. J Psychiatr Res 2013; 47:586-91. [PMID: 23357208 DOI: 10.1016/j.jpsychires.2012.12.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/10/2012] [Accepted: 12/14/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Suicide represents a leading cause of death in young people, yet relatively little is known regarding the neurobiological sequelae of preceding suicidal thoughts and behaviours. Although some studies have reported cognitive deficits associated with suicidality, very few studies have been undertaken in young people, especially from non-clinical contexts. AIMS To quantify cognitive deficits associated with suicidality using a representative sample of young people, recruited from the general community using media advertisements. METHOD 304 adults (18-29 years) undertook the Mini-International Neuropsychiatric Inventory (MINI) suicidality module, along with Cambridge Gamble and Stop-Signal tasks. Suicidality was defined as non-zero MINI scores (broad definition) and a past history of suicide attempt(s) (narrow definition). Clinical features and cognitive performance were compared between those with and those without suicidality, using analysis of variance/chi-square; findings were further explored using linear regression. RESULTS Suicidality was relatively common (broad definition: 14.8%; narrow definition: 5.3%) in young people and was associated with impaired decision-making on the Cambridge Gamble task (p < 0.05, Bonferroni corrected at the analysis level of each suicidality definition). Linear regression demonstrated that decision-making performance was associated with a significant incremental benefit with respect to predicting suicidality, over and above the utility of demographic and clinical variables considered (p < 0.05 uncorrected). CONCLUSIONS Impaired decision-making exists in young people with suicidality, and may thereby predispose towards a range of suicidal thoughts and behaviours. Further work is needed to clarify the chain of progression from such thoughts/behaviours, which are relatively common, through to actual suicide, which is not.
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Suicidal behavior among Muslim Arabs in Israel. Soc Psychiatry Psychiatr Epidemiol 2012; 47:11-7. [PMID: 21305264 DOI: 10.1007/s00127-010-0307-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 10/18/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE Countries with Muslim populations report relatively lower rates of suicide. However, authors have noted methodological flaws in the data. This study examined reliable rates of completed suicide, suicide ideation, planning and attempts among Muslims as compared to Jews in Israel. METHODS For completed suicide, information was extracted from death certificates (2003-2007); the National Emergency Room Admissions Database (NERAD) provided data on suicide attempts (2003-2007); and the Israel National Health Survey (INHS) (2003-2004) was used for self reports on lifetime suicide ideation, planning and attempts. RESULTS Completed suicide rates among Muslim-Israelis (3.0 per 100,000) were lower compared to Jewish-Israelis (8.2 per 100,000). Based on NERAD, attempted suicide rates among men were lower for Muslims compared to Jews, while among women aged 15-44 no differences were found. In the INHS, the rate of self-reported lifetime suicide attempts was significantly higher among Muslims (2.8%) compared to Jews (1.2%), while lifetime prevalence rates of suicide ideation (6.6%) and planning (2.1%) in Muslims did not differ from Jews (5.2 and 1.9%, respectively). CONCLUSIONS Conceivably, the lower rate of completed suicide among Muslim-Israelis might be explained by the strenuous proscription of suicide by the Koran. However, its extension to suicide attempts is equivocal: attempts were higher among Muslims than among Jews according to self-reports but lower in the NERAD records. Social pressures exerted on the reporting agents may bias the diagnosis of self-harm in both the latter data source and in the death certificates.
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Devries K, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, Heise L, Durand J, Mbwambo J, Jansen H, Berhane Y, Ellsberg M, Garcia-Moreno C. Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women's health and domestic violence against women. Soc Sci Med 2011; 73:79-86. [PMID: 21676510 DOI: 10.1016/j.socscimed.2011.05.006] [Citation(s) in RCA: 320] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 04/19/2011] [Accepted: 05/06/2011] [Indexed: 11/17/2022]
Abstract
Suicidal behaviours are one of the most important contributors to the global burden of disease among women, but little is known about prevalence and modifiable risk factors in low and middle income countries. We use data from the WHO multi-country study on women's health and domestic violence against women to examine the prevalence of suicidal thoughts and attempts, and relationships between suicide attempts and mental health status, child sexual abuse, partner violence and other variables. Population representative cross-sectional household surveys were conducted from 2000-2003 in 13 provincial (more rural) and city (urban) sites in Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia, Thailand and Tanzania. 20967 women aged 15-49 years participated. Prevalence of lifetime suicide attempts, lifetime suicidal thoughts, and suicidal thoughts in the past four weeks were calculated, and multivariate logistic regression models were fit to examine factors associated with suicide attempts in each site. Prevalence of lifetime suicide attempts ranged from 0.8% (Tanzania) to 12.0% (Peru city); lifetime thoughts of suicide from 7.2% (Tanzania province) to 29.0% (Peru province), and thoughts in the past four weeks from 1.9% (Serbia) to 13.6% (Peru province). 25-50% of women with suicidal thoughts in the past four weeks had also visited a health worker in that time. The most consistent risk factors for suicide attempts after adjusting for probable common mental health disorders were: intimate partner violence, non-partner physical violence, ever being divorced, separated or widowed, childhood sexual abuse and having a mother who had experienced intimate partner violence. Mental health policies and services must recognise the consistent relationship between violence and suicidality in women in low and middle income countries. Training health sector workers to recognize and respond to the consequences of violence may substantially reduce the health burden associated with suicidal behaviour.
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Affiliation(s)
- Karen Devries
- London School of Hygiene & Tropical Medicine (LSHTM), Public Health and Policy, 36 Gordon Square, London WC1H 0DP, United Kingdom.
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Similarity in depressive symptom profile in a population-based study of migrants in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 2010; 45:941-51. [PMID: 19763363 DOI: 10.1007/s00127-009-0135-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 08/25/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Depression is a clinical syndrome developed in Western Europe and North-America. The expression of symptoms and the impact of symptoms on functioning may therefore be expected to vary across cultures and languages. Our first aim was to study differences in depressive symptom profile between indigenous and non-Western immigrant populations in the Netherlands. We hypothesized that differences in expression of depressive symptoms would be more likely in the domains of mood and cognitions, and less likely in the domains of psychomotor and vegetative symptoms. Our second aim was to study ethnic differences in the association of depressive symptoms and general functioning. METHOD In a random community sample stratified for ethnicity in Amsterdam, the Netherlands, depressive symptoms were assessed by bilingual interviewers using the Composite International Diagnostic Interview (CIDI 2.1) and the Symptom Checklist-90-Revised (SCL-90-R). Impairments in functioning were measured by the World Health Organization Disability Assessment Schedule II (WHODAS II). Results were obtained from 812 subjects: N = 321 native Dutch, N = 213 Turkish-Dutch, N = 191 Moroccan-Dutch, N = 87 Surinamese-Dutch. Differences in depressive symptom expression were tested by differential item functioning. RESULTS The prevalence of DSM-IV depressive disorder and the overall level of depressive symptoms were higher in the Turkish and Moroccan immigrant groups compared to native Dutch subjects. Ethnic differences in item functioning of depressive symptoms were rare, and equally unlikely in all four symptom domains. Depression was equally associated with functional impairment across ethnic groups. CONCLUSION Although depressive symptoms were more common among migrants than in the indigenous population, both the depressive symptom profile and the associated functional impairments were comparable. These findings may help diminishing concerns about the validity of using existing diagnostic procedures among ethnic minority groups.
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Kadri N, Agoub M, Assouab F, Tazi MA, Didouh A, Stewart R, Paes M, Toufiq J, Moussaoui D. Moroccan national study on prevalence of mental disorders: a community-based epidemiological study. Acta Psychiatr Scand 2010; 121:71-4. [PMID: 19681770 DOI: 10.1111/j.1600-0447.2009.01431.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The main objective of this study was to assess the prevalence of common mental disorders in the Moroccan general population. METHOD On a systematic representative randomized sample, the Moroccan Arabic version of the Mini International Neuropsychiatric Interview (MINI) was used to assess the prevalence of mood, anxiety, substance, and alcohol abuse disorders. RESULTS Among 5498 subjects interviewed, 40.1% had at least one current mental disorder. Current major depressive disorder was the most common (26.5%), and at least one anxiety disorder was found in 37% of the sample. Mental disorders were more frequent among female, urban, divorced, and unemployed subjects. CONCLUSION Mental disorders are common in the Moroccan general population, particularly mood and anxiety disorders.
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Affiliation(s)
- N Kadri
- Ibn Rushd University Psychiatric Centre, Casablanca, Morocco.
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Prevalence of suicide thoughts, plans and attempts in a community sample from Karaj, Iran. Community Ment Health J 2009; 45:37-41. [PMID: 19051014 DOI: 10.1007/s10597-008-9173-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 11/12/2008] [Indexed: 10/21/2022]
Abstract
Aim of this study was to evaluate the prevalence of suicide ideation and behavior in a community sample of an Iranian city, Karaj. Study sample consisted of 2,300 subjects, chosen randomly from the community. The WHO/SUPRE-MISS survey questionnaire, used in this study. Lifetime prevalence for suicide thoughts, plans and attempts were 12.7, 6.2 and 3.3%, respectively and for the previous year they were 5.7, 2.9 and 1%, respectively. Although it is not possible to generalize the results to the country, but in some area of Iran, the prevalence of suicide ideation, plan and attempt appeared to be similar to that of many developed countries.
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Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. Suicide and suicidal behavior. Epidemiol Rev 2008; 30:133-54. [PMID: 18653727 DOI: 10.1093/epirev/mxn002] [Citation(s) in RCA: 1474] [Impact Index Per Article: 92.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.
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Affiliation(s)
- Matthew K Nock
- Department of Psychology, Harvard University, 33 Kirkland Street, Room 1280, Cambridge, MA 02138, USA.
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26
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Bernal M, Haro JM, Bernert S, Brugha T, de Graaf R, Bruffaerts R, Lépine JP, de Girolamo G, Vilagut G, Gasquet I, Torres JV, Kovess V, Heider D, Neeleman J, Kessler R, Alonso J. Risk factors for suicidality in Europe: results from the ESEMED study. J Affect Disord 2007; 101:27-34. [PMID: 17074395 DOI: 10.1016/j.jad.2006.09.018] [Citation(s) in RCA: 359] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 09/20/2006] [Accepted: 09/20/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Precise knowledge of the epidemiology of suicidality provides necessary information for designing prevention programs. The aims of the present study were to investigate the prevalence and correlates of suicidal ideas and attempts in the general population of Europe. METHODS The European Study on the Epidemiology of Mental Disorders (ESEMED) is a cross-sectional household survey carried out in a probability representative sample of non-institutionalised adults (aged 18 years or older) of six European countries (Belgium, France, Germany, Italy, the Netherlands and Spain). The Composite International Diagnostic Interview (CIDI 3.0) was administered to 21,425 individuals. RESULTS Lifetime prevalence of suicidal ideation was 7.8% and of suicidal attempts 1.3%. Being women, younger and divorced or widowed were associated with a higher prevalence of suicide ideation and attempts. Psychiatric diagnoses were strongly related to suicidality. Among them, major depressive episode (Rate ratio 2.9 for lifetime ideas and 4.8 for lifetime attempts), dysthymia (RR 2.0 and 1.6), GAD (RR 1.8 and 2.3 for lifetime), PTSD (RR 1.9 and 2.0) and alcohol dependence (RR 1.7 and 2.5) were the most important. Population attributable risks for lifetime suicidal attempt was 28% for major depression. LIMITATIONS Information about suicidal ideas and attempts was self reported, psychiatric diagnoses were made using fully structured lay interviews rather than clinician-administered interviews. CONCLUSIONS In spite of meaningful country variation in prevalence, risk factors for suicidality are consistent in the European countries. Population prevention programmes should focus on early diagnosis and treatment of major depression and alcohol abuse and in those individuals with recent appearance of suicidal ideas.
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Affiliation(s)
- M Bernal
- Sant Joan de Déu-Serveis de Salut Mental, Fundació Sant Joan de Déu, Dr Antoni Pujades 42, 08830, Sant Boi de Llobregat, Spain
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