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Matinnia N, Alafchi B, Haddadi A, Ghaleiha A, Davari H, Karami M, Taslimi Z, Afkhami MR, Yazdi-Ravandi S. Anticipating influential factors on suicide outcomes through machine learning techniques: Insights from a suicide registration program in western Iran. Asian J Psychiatr 2024; 100:104183. [PMID: 39079418 DOI: 10.1016/j.ajp.2024.104183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 07/27/2024] [Indexed: 09/13/2024]
Abstract
Suicide is a global public health concern, with increasing rates observed in various regions, including Iran. This study focuses on the province of Hamadan, Iran, where suicide rates have been on the rise. The research aims to predict factors influencing suicide outcomes by leveraging machine learning techniques on the Hamadan Suicide Registry Program data collected from 2016 to 2017. The study employs Naïve Bayes and Random Forest algorithms, comparing their performance to logistic regression. Results highlight the superiority of the Random Forest model. Based on the variable importance and multiple logistic regression analyses, the most important determinants of suicide outcomes were identified as suicide method, age, and timing of attempts, income, and motivation. The findings emphasize the cultural context's impact on suicide methods and underscore the importance of tailoring prevention programs to address specific risk factors, especially for older individuals. This study contributes valuable insights for suicide prevention efforts in the region, advocating for context-specific interventions and further research to refine predictive models and develop targeted prevention strategies.
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Affiliation(s)
- Nasrin Matinnia
- Nursing Department, Faculty of Medical Sciences, Hamedan Branch, Islamic Azad University, Hamedan, Islamic Republic of Iran
| | - Behnaz Alafchi
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Arya Haddadi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Ali Ghaleiha
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Hasan Davari
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Manochehr Karami
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Taslimi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran; Fertility and Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Mohammad Reza Afkhami
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Saeid Yazdi-Ravandi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
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Kameyama H, Sugimoto K, Kodaka F, Okuno K, Masaki T, Nukariya K, Shigeta M. Association between the early repolarization pattern and nocturnal suicide attempts. Neuropsychopharmacol Rep 2024; 44:410-416. [PMID: 38494338 PMCID: PMC11144600 DOI: 10.1002/npr2.12433] [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: 12/25/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
AIM Numerous recent reports have highlighted the association between mental disorders and electrocardiographic findings. The early repolarization pattern (ERP) on electrocardiogram has been linked with a history of suicide attempts and attention deficit hyperactivity disorder, and associations with impulsivity have also been reported. It is known that suicidal intent is more common at night. Patients who have a mental disorder and ERP may have a higher likelihood of impulsivity, potentially increasing the risk of suicide at night. METHODS The subjects were 43 patients with a history of suicide attempts who had undergone electrocardiographic examination at Jikei University School of Medicine Kashiwa Hospital and received intervention from our department. Due to the diurnal variation in electrocardiographic findings, only patients who underwent the examination during the daytime were included. Patients' clinical backgrounds were compared according to the presence or absence of ERP, and the association between nocturnal suicide attempts and ERP was examined using multivariate analysis. RESULTS The frequency of nocturnal suicidal behavior was 76.2% in patients with ERP and 31.8% in those without ERP, but the difference was not significant after Bonferroni correction. In the multivariate analysis, there was a significant association of ERP with nocturnal suicide attempts (p = 0.018). CONCLUSION The finding of an association between ERP and nocturnal suicide attempts indicates that ERP is a biological indicator that can predict nocturnal suicide attempts.
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Affiliation(s)
- Hiroshi Kameyama
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan
- Department of PsychiatryThe Jikei University Kashiwa HospitalChibaJapan
| | - Kenichi Sugimoto
- Department of Laboratory MedicineThe Jikei University School of MedicineTokyoJapan
| | - Fumitoshi Kodaka
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan
| | - Kenji Okuno
- Department of Emergency MedicineThe Jikei University Kashiwa HospitalChibaJapan
| | - Takahiro Masaki
- Department of Laboratory MedicineThe Jikei University School of MedicineTokyoJapan
| | - Kazutaka Nukariya
- Department of PsychiatryThe Jikei University Kashiwa HospitalChibaJapan
| | - Masahiro Shigeta
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan
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Bourdin V, Mulier G, Calle S, Minart N, Charlier P. The last jump: epidemiology of suicides at the Tour Eiffel (Paris) between 1950 and 1989. Forensic Sci Med Pathol 2024; 20:360-369. [PMID: 38085425 DOI: 10.1007/s12024-023-00707-1] [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] [Accepted: 08/28/2023] [Indexed: 08/03/2024]
Abstract
The Eiffel Tower (Paris, France) has been attracting many candidates for suicide over the years. The aim of this study was to determine the patterns of people who committed suicide by jumping. Permission to access the unpublished records of the Paris Police Prefecture made it possible to compile press articles related to suicides from April 1950 to March 1989. 155 articles corresponding to 79 cases were kept for analysis. There were significantly more males (66%), as compared with an expected theoretical distribution of 1/2 for each sex (p = 0.002). Median age was 38.0 years old. Suicide peak was reached during the months of August and October (13% for each), while February was poor in suicides (3%). Tuesdays and Saturdays were the more impacted days. Hourly suicide rates were 8% (morning), 11% (noon), 7% (afternoon), and 5% (evening-night). Moon phases did not correlate with suicide occurrence. The main context described was that of a psychiatric pathology (49%). Death occurred in 92% of the reported cases. Sex ratio, ages, decrease during the cold season, no association with moon phases, and underlying psychiatric pathologies were consistent with trends for either all-cause suicides or suicide jumps from a platform. Conversely, unusual trough in suicides on Mondays and noon peak in suicide rate have been, respectively, attributed to small sample size and closure at night. As jumping corresponds to both ease and proximity, we believe the implementation of protective measures in the early 1960s succeeded in reducing the number of suicides overall.
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Affiliation(s)
- Virginie Bourdin
- Direction Département de la Recherche et de l'Enseignement, Musée du Quai Branly - Jacques Chirac, 222 rue de l'Université, 75007, Paris, France.
- Laboratoire Anthropologie, Archéologie, Biologie (LAAB), Université Paris-Saclay (UVSQ), UFR des Sciences de la Santé, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France.
| | - Guillaume Mulier
- Département de biostatistiques et d'épidémiologie, Institut Gustave Roussy, 94800, Villejuif, France
| | - Sophie Calle
- Perrotin, 2bis avenue Matignon, 75008, Paris, France
| | - Nathalie Minart
- Archives of the Police Prefecture of Paris, 25-27 rue Baudin, 93310, Le Pré-Saint-Gervais, France
| | - Philippe Charlier
- Direction Département de la Recherche et de l'Enseignement, Musée du Quai Branly - Jacques Chirac, 222 rue de l'Université, 75007, Paris, France
- Laboratoire Anthropologie, Archéologie, Biologie (LAAB), Université Paris-Saclay (UVSQ), UFR des Sciences de la Santé, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France
- Fondation Anthropologie, Archéologie, Biologie (FAAB) - Institut de France, Palais de l'Institut, 23 quai de Conti, 75006, Paris, France
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Liu D, Zhang M, Ding L, Huang J, Wang Y, Su Y, Chen Z, Cai Y, He S, Peng D. Relationship between biological rhythm dysregulation and suicidal ideation in patients with major depressive disorder. BMC Psychiatry 2024; 24:87. [PMID: 38297264 PMCID: PMC10832079 DOI: 10.1186/s12888-024-05528-2] [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: 08/10/2023] [Accepted: 01/16/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Although the disturbance of circadian rhythms represents a significant clinical feature of major depressive disorder (MDD), the relationship between biological rhythm disturbances and the severity of suicidal ideation in individuals with MDD remains unclear. We aimed to explore the characteristics of different biological rhythm dimensions in MDD and their association with the severity of depressive symptoms and suicidal ideation. METHODS A total of 50 MDD patients and 50 healthy controls were recruited and their general information was collected. The severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HDRS17). The intensity of suicidal ideation was evaluated with the Beck Scale for Suicide Ideation (BSS). The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scale was utilized to assess the participants' biological rhythm dysregulation. Multiple logistic regression analysis was conducted to explore the relationship between biological rhythm and the risk of MDD. Multiple linear regression analysis was performed in the MDD group to investigate the relationship between different biological rhythm dimensions and suicide ideation. RESULTS Significant differences were observed between the MDD group and the control group in total BRIAN score (Z=-5.41, P < 0.001) as well as scores for each dimension. After adjusting for confounding factors, multiple logistic regression analysis revealed a significant association between total BRIAN score and the presence of MDD (OR = 1.20, 95% CI = 1.10-1.29, P < 0.001), as well as between scores in different BRIAN dimensions and the presence of MDD (activity: OR = 1.47, 95% CI = 1.24-1.74, P < 0.001; sleep: OR = 1.52, 95% CI = 1.28-1.79, P < 0.001; social: OR = 1.80, 95% CI = 1.32-2.46, P < 0.001; eating pattern: OR = 1.34, 95% CI = 1.12-1.60, P = 0.001). In patients with MDD, linear regression analysis demonstrated a positive relationship between BSS scores and BRIAN eating pattern scores (β = 0.34, P = 0.022), even after adjusting for demographic factors and the severity of depression. CONCLUSIONS Patients with MDD exhibited significantly higher levels of dysregulation in all four biological rhythm dimensions compared to healthy controls and the degree of dysregulation was associated with the severity of depression. More importantly, dysregulation of eating pattern may increase the intensity of suicidal ideation in MDD, thus elevating the risk of suicide.
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Affiliation(s)
- Dan Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Min Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Lei Ding
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Jia Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yousong Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Zheng Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yiyun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Shen He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China.
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China.
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Az A, Orhan C, Sogut O. Suicide attempts and the factors that lead to suicidal ideation: A 3-year analysis. North Clin Istanb 2023; 10:745-753. [PMID: 38328720 PMCID: PMC10846586 DOI: 10.14744/nci.2023.81598] [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: 09/15/2022] [Revised: 11/05/2022] [Accepted: 01/07/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE We explored the epidemiological characteristics of suicide attempts and identified suicide trends and associated factors. METHODS This retrospective, cross-sectional, observational, and single-center study included consecutive 412 patients who were admitted to Emergency Department for follow-up and treatment after a suicide attempt between June 2019 and June 2022. We assessed patient demographics, suicidal behavior, previous suicide attempts, psychiatric disorders, drug use, visits to the psychiatry clinic within the past 6 months, the persistence of suicidal ideation, and clinical outcomes. RESULTS The study population consisted of 259 females (62.86%) and 153 males (37.14%), with a mean age of 29.50±11.51 (range: 13-72) years. Females attempted suicide more often than males, but suicide completion was more common in males. Overall, 79.37% (n=327) of the suicide attempters were aged <40 years and most were 20-29 years old (n=147, 35.68%). Non-fatal suicide attempts were more common in single, unemployed, and poorly educated individuals, but this was not the case for suicide completers. However, there was no significant difference in marital status, education, and occupation among suicide completers. Drug poisoning was the major form of suicide attempt (n=345, 83.74%). Mental disorders, family or relationship conflicts, and separation from a partner were common causes of suicidal ideation. Patient numbers were particularly high in the autumn (i.e., September), and at night. CONCLUSION Females, young adults, singletons, the unemployed, and individuals with psychiatric disorders and low education levels are more likely to attempt suicide, particularly during hours when they are likely to be alone.
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Affiliation(s)
- Adem Az
- Department of Emergency Medicine, Istanbul Provincial Health Directorate Beylikduzu Public Hospital, Istanbul, Turkiye
| | - Cigdem Orhan
- Department of Emergency Medicine, Istanbul Provincial Health Directorate Beylikduzu Public Hospital, Istanbul, Turkiye
| | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
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Park GWV, Cho SI. Monday peak is unique to suicide? Comparison of weekly distribution by causes of death using national representative cohort database. Suicide Life Threat Behav 2023; 53:613-627. [PMID: 37166224 DOI: 10.1111/sltb.12968] [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: 12/02/2022] [Revised: 03/16/2023] [Accepted: 04/15/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION The excess suicide mortality on Monday was reported in numerous studies. However, it is uncertain that the uneven weekly distribution of deaths is observed among suicide, or common among various causes of death. METHODS Weekly distributions of suicide and other causes of death from 2012 to 2017 in South Korea were compared. Logistic regression models were fitted to investigate the association between causes of death and day-of-the-week effects. We also fitted conditional logistic regression models after age and gender matching. RESULTS A total of 1,622,213 deaths, including 80,492 suicide decedents, were analyzed. A total of 16.0% of suicide deaths occurred on Monday, whereas 12.4% on Saturday and 13.0% on Sunday. Suicide decedents were more likely to die on Monday than other causes of deaths after controlling sociodemographic factors in unmatched data. However, there was no evidence of excess suicide deaths on Mondays than other days in contrast to matched death controls. CONCLUSION While the increase in mortality on Mondays was not unique to suicide, our findings have suicide prevention implications. Mental health practitioners should consider providing additional mental health resources on earlier working days. Workplace mental health programs to reduce psychological burdens of employees could help to prevent suicide during working days.
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Affiliation(s)
- Gun Woo Victor Park
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Sung-Il Cho
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute for Health and Environment, Seoul National University, Seoul, South Korea
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Hashimoto T, Kaneda Y, Ozaki A, Hori A, Tsuchiya T. Eleven-Year Trend of Drug and Chemical Substance Overdose at a Local Emergency Hospital in Japan. Cureus 2022; 14:e32475. [PMID: 36644086 PMCID: PMC9835393 DOI: 10.7759/cureus.32475] [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: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate long-term trends of overdose in the emergency department of a regional core hospital in Sendai, Miyagi Prefecture, Japan, and to identify patient characteristics as well as drugs and chemicals associated with overdose. METHODS Patients who visited the emergency department from January 1, 2010, to December 31, 2020, and were diagnosed with a drug or chemical overdose were included in the study. We conducted a descriptive analysis based on the data collected. RESULTS In total, 577 patients (mean 38.4 years old, female 75.0%) were considered, and 16.8% had a history of repeated overdose. The number of patients during the study period showed a downward trend, with slight increases in 2012 and 2020. In addition, the top four drugs suspected of causing overdose were over the counter (OTC) antipyretic analgesics and cold medicines (N=97), followed by flunitrazepam (N=80), etizolam (N=72), and brotizolam (N=70). CONCLUSION There was a decreasing trend in overdose, and OTC medicines, sedatives, and anxiolytics were the primary medications causing overdose. OTC antipyretic analgesics and cold medicines were the most common suspected overdose drugs, with an increasing trend in the later years.
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Affiliation(s)
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo, JPN
| | - Akihiko Ozaki
- Breast Surgery, Jyoban Hospital, Tokiwa Foundation, Iwaki, JPN
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Al-qaim ZH, Owadh HKH, Ali SA, Hussein AS, Ameen TR, Kolemen A, Washi GA, Jalil AT. COVID-19 vaccination in patients with cancer: Opportunities and challenges. Front Oncol 2022; 12:1029325. [PMID: 36425557 PMCID: PMC9679654 DOI: 10.3389/fonc.2022.1029325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/17/2022] [Indexed: 09/26/2023] Open
Abstract
The rapid spread of the SARS-Cov-2 virus, the increase in the number of patients with severe COVID-19, and the high mortality rate created the basis for the production of safe and effective vaccines. Studies have confirmed the increased risk of severe Covid-19 disease and mortality in cancer patients. It is logical that cancer patients should be the first to receive the primary vaccination and the booster vaccine for Covid-19. Since studies related to cancer patients and the effectiveness of existing Covid-19 vaccines have not been widely conducted, there are significant uncertainties about the effectiveness of the vaccine and the level of humoral and cellular immune responses in these patients. As a result, the possible risks and side effects of existing vaccines are not clear for patients with different cancers who are undergoing special treatments. In this study, we will discuss the effectiveness and safety of existing vaccines on cancer patients. In addition, we highlight factors that could affect the effectiveness of vaccines in these patients and finally discuss opportunities and challenges related to vaccination in cancer patients.
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Affiliation(s)
- Zahraa Haleem Al-qaim
- Anesthesia Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | | | - Sarah A. Ali
- Department of Medical Laboratory Techniques, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Alaa S. Hussein
- Radiological Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | | | - Ayshan Kolemen
- Department of Dentistry, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Ghassan A. Washi
- Department of Nursing, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Abduladheem Turki Jalil
- Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
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Tubbs AS, Fernandez FX, Grandner MA, Perlis ML, Klerman EB. The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 1:830338. [PMID: 35538929 PMCID: PMC9083440 DOI: 10.3389/fnetp.2021.830338] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Sufficient sleep with minimal interruption during the circadian/biological night supports daytime cognition and emotional regulation. Conversely, disrupted sleep involving significant nocturnal wakefulness leads to cognitive and behavioral dysregulation. Most studies to-date have examined how fragmented or insufficient sleep affects next-day functioning, but recent work highlights changes in cognition and behavior that occur when someone is awake during the night. This review summarizes the evidence for day-night alterations in maladaptive behaviors, including suicide, violent crime, and substance use, and examines how mood, reward processing, and executive function differ during nocturnal wakefulness. Based on this evidence, we propose the Mind after Midnight hypothesis in which attentional biases, negative affect, altered reward processing, and prefrontal disinhibition interact to promote behavioral dysregulation and psychiatric disorders.
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Affiliation(s)
- Andrew S. Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine—Tucson, Tucson, AZ, United States
| | - Fabian-Xosé Fernandez
- Department of Psychology, Evelyn F Mcknight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine—Tucson, Tucson, AZ, United States
| | - Michael L. Perlis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, United States
| | - Elizabeth B. Klerman
- Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Behera C, Sikary AK. Suicidal deaths in pregnancy at an apex institute in India: A retrospective analysis of autopsy cases. Asian J Psychiatr 2022; 68:102979. [PMID: 34973633 DOI: 10.1016/j.ajp.2021.102979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Suicidal behavior in pregnancy is a known fact worldwide. However, the published literature is still debating whether pregnancy is associated with an increase in the risk of suicide. Nonetheless, this is an important phenomenon that should not be ignored as the life of an unborn fetus is involved. The present study is a retrospective analysis of suicide death in pregnancy for the years 2011-2020 to study the different parameters. METHODS The cases were collected from the archives of the department with due permission from the authority. Data were analyzed according to the age of the victim, duration of pregnancy, and time and cause of death. RESULT The commonest age group was 21-25 years, the time of death was mostly during the daytime, and most of the deaths were due to hanging. These findings are not unusual in comparison to the general population. The pregnancy duration of most of the cases was first and second trimester, and third-trimester pregnancy accounted for far less number. In contrast, some studies showed that suicidal ideation and depression were more common during the first trimester and third trimester. Most of the pregnant women were pregnant with male fetuses. CONCLUSION Though suicidal ideation is more during the first and third trimester, suicide occurs mostly in the first and second trimester, with third-trimester suicide deaths being far less. Being pregnant with a male fetus might be a risk factor in comparison to having female fetuses. These are two aspects that need to be explored further.
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Affiliation(s)
- Chittaranjan Behera
- Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Asit Kumar Sikary
- Department of Forensic Medicine, Rama Medical College Hospital and Research Centre, Kanpur, India.
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Sato T, Sakai K, Nakada R, Shiraishi T, Tanabe M, Komatsu T, Sakuta K, Terasawa Y, Umehara T, Omoto S, Mitsumura H, Murakami H, Matsushima M, Iguchi Y. Employment Status Prior to Ischemic Stroke and Weekly Variation of Stroke Onset. J Stroke Cerebrovasc Dis 2021; 30:105873. [PMID: 34051450 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/24/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the differences in clinical backgrounds, especially weekly variations of stroke occurrence, between hyper-acute ischemic stroke patients with and without regular employment (RE), as well as the impact of RE on outcome. MATERIALS AND METHODS Symptomatic ischemic stroke patients with ≤4.5 h from onset to door were enrolled. First, we divided patients into the RE and non-RE group to analyze differences in clinical characteristics, especially relation between weekly variations of stroke occurrence and RE. Second, we divided the same patients into those with and without favorable outcomes (modified Rankin Scale score of 0 to 2 at 3 months from stroke onset) to analyze the impact of RE on outcomes. RESULTS We screened 1,249 consecutive symptomatic ischemic stroke patients and included 377 patients (284 [75%] males; median age, 67 years). Of these patients, 248 (66%) were included in RE group. First, RE was independently associated with occurrence of stroke on Monday in reference to Sunday or a public holiday (OR 2.562, 95% CI 1.004-6.535, p = 0.049). Second, RE (OR 2.888 95% CI 1.378-6.050, p = 0.005) was a factor independently associated with a favorable outcome. CONCLUSIONS Patients with RE were more likely to have a hyper-acute ischemic stroke on Monday in reference to Sunday or a public holiday. However, RE before stroke onset appears to have a positive impact on outcome.
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Affiliation(s)
- Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoji Nakada
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomotaka Shiraishi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Maki Tanabe
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuka Terasawa
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shusaku Omoto
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
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Dutta R, Gkotsis G, Velupillai S, Bakolis I, Stewart R. Temporal and diurnal variation in social media posts to a suicide support forum. BMC Psychiatry 2021; 21:259. [PMID: 34011346 PMCID: PMC8136175 DOI: 10.1186/s12888-021-03268-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rates of suicide attempts and deaths are highest on Mondays and these occur more frequently in the morning or early afternoon, suggesting weekly temporal and diurnal variation in suicidal behaviour. It is unknown whether there are similar time trends on social media, of posts relevant to suicide. We aimed to determine temporal and diurnal variation in posting patterns on the Reddit forum SuicideWatch, an online community for individuals who might be at risk of, or who know someone at risk of suicide. METHODS We used time series analysis to compare date and time stamps of 90,518 SuicideWatch posts from 1st December 2008 to 31st August 2015 to (i) 6,616,431 posts on the most commonly subscribed general subreddit, AskReddit and (ii) 66,934 of these AskReddit posts, which were posted by the SuicideWatch authors. RESULTS Mondays showed the highest proportion of posts on SuicideWatch. Clear diurnal variation was observed, with a peak in the early morning (2:00-5:00 h), and a subsequent decrease to a trough in late morning/early afternoon (11:00-14:00 h). Conversely, the highest volume of posts in the control data was between 20:00-23:00 h. CONCLUSIONS Posts on SuicideWatch occurred most frequently on Mondays: the day most associated with suicide risk. The early morning peak in SuicideWatch posts precedes the time of day during which suicide attempts and deaths most commonly occur. Further research of these weekly and diurnal rhythms should help target populations with support and suicide prevention interventions when needed most.
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Affiliation(s)
- Rina Dutta
- Department of Psychological Medicine, School of Academic Psychiatry, King’s College London, IoPPN, PO Box 84, 3rd Floor East Wing, Room E3.07, De Crespigny Park, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - George Gkotsis
- Department of Psychological Medicine, School of Academic Psychiatry, King’s College London, IoPPN, PO Box 84, 3rd Floor East Wing, Room E3.07, De Crespigny Park, London, SE5 8AF UK
| | - Sumithra Velupillai
- Department of Psychological Medicine, School of Academic Psychiatry, King’s College London, IoPPN, PO Box 84, 3rd Floor East Wing, Room E3.07, De Crespigny Park, London, SE5 8AF UK
- School of Electrical Engineering and Computer Science, KTH, Stockholm, Sweden
| | - Ioannis Bakolis
- Department of Psychological Medicine, School of Academic Psychiatry, King’s College London, IoPPN, PO Box 84, 3rd Floor East Wing, Room E3.07, De Crespigny Park, London, SE5 8AF UK
| | - Robert Stewart
- Department of Psychological Medicine, School of Academic Psychiatry, King’s College London, IoPPN, PO Box 84, 3rd Floor East Wing, Room E3.07, De Crespigny Park, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, UK
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13
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Onoya ED, Makwakwa NL, Motloba DP. Temporal variation in suicide in peri-urban Pretoria. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 34082560 PMCID: PMC8377945 DOI: 10.4102/safp.v63i1.5260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 03/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Suicide is a public health problem, and the third major cause of death in Indian, black and mixed race groups. In whites suicide is the second cause of death. The patterns of suicide vary by time of day, day of the week, month of the year and seasons. As a result of limited and inaccurate data, these variations have not been fully examined in the developing world. This study investigated the diurnality and seasonality of suicide in peri-urban Pretoria, as opposed to studies conducted previously in the country’s metropolitan. Methods A retrospective analysis of suicides recorded between 2007 and 2019 was undertaken. Data were extracted from the forensic pathology department’s database (university mortuary). Results Of the 1515 cases of suicides examined, majority were black Africans (95.9%), male (83.9%), aged 21–40 years (50.5%). Hanging was the most common method of suicide irrespective of demographics (72.8%). Diurnal suicide variations were distinct for men and women, occurring at (16:00–20:00) and (08:00–12:00), respectively. Suicide peaked on days preceding and after the weekend (Mondays and Fridays) and in warmer seasons (summer and spring) Conclusion The overall patterns of suicide in peri-urban Pretoria, mimic local and global trends with regard to methods, demographics and temporal characteristics. The underlying mechanism for these trends is unclear requiring in-depth investigation in order to develop appropriate interventions.
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Affiliation(s)
- Eric D Onoya
- Department of Forensic Pathology, School of Medicine, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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14
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Kuderer NM, Hill JA, Carpenter PA, Lyman GH. Challenges and Opportunities for COVID-19 Vaccines in Patients with Cancer. Cancer Invest 2021; 39:205-213. [PMID: 33534645 DOI: 10.1080/07357907.2021.1885596] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Given the rapidly expanding global spread of the SARS-Co-V-2 virus and the expanding number of individuals with the serious and potentially fatal illness, COVID-19, there is an urgent need for safe and effective vaccines. Based on compelling evidence that patients with cancer are at increased risk for greater morbidity and mortality with COVID-19, several professional organizations have provided early guidance on the role of COVID-19 vaccines in patients with malignant disease. In this commentary we review the available data on the efficacy and safety of the approved and forthcoming vaccines in patients with cancer. Based on a review of the totality of available evidence, we recommend that most patients with cancer should receive the recommended dose and schedule of one of the COVID-19 vaccines when available. We encourage industry, regulators and professional research organizations to carefully track the efficacy and safety of COVID-19 vaccination in patients with cancer in the real world setting and routinely report unanticipated adverse events and signs of loss of efficacy. Particular attention is needed for patients on active cancer therapy to carefully evaluate efficacy and safety in relationship to the timing of vaccination relative to that of active cancer treatment and immunosuppression.
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Affiliation(s)
| | - Joshua A Hill
- Department of Medicine, University of Washington, Seattle, Washington, USA.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Gary H Lyman
- Department of Medicine, University of Washington, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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Oliveira JWTD, Magalhães APND, Barros AC, Monteiro EKR, Souza CDFD, Alves VDM. Características das tentativas de suicídio atendidas pelo serviço de emergência pré-hospitalar: um estudo epidemiológico de corte transversal. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo: Descrever o perfil das vítimas de tentativas de suicídio atendidas pelo Corpo de Bombeiros de um município do semiárido brasileiro. Métodos: Estudo transversal contendo dados do atendimento a vítimas de tentativas de suicídio, realizado pelos bombeiros militares do estado de Alagoas, no período de 1º de janeiro de 2000 a 31 de dezembro de 2017. Foram selecionadas as variáveis: sexo, idade, desfecho, intoxicação, uso de álcool, transtorno mental, estação do ano, dia da semana, horário, natureza da ocorrência e tempo de resposta, de transporte e total. Foram utilizados os testes qui-quadrado, exato de Fisher e Kruskal-Wallis. Resultados: Foram atendidas 144 vítimas de tentativas de suicídio. A frequência de atendimentos entre homens (n = 73; 50,7%) e mulheres (n = 71; 49,3%) foi semelhante. As mulheres apresentaram idade mais jovem (p < 0,001) e utilizaram o método da intoxicação (p < 0,001) duas vezes mais que os homens. A presença de transtorno mental (p = 0,04) foi mais comum entre os homens e o tempo consumido durante o atendimento pré-hospitalar foi maior entre eles, indicando que, possivelmente, as tentativas de suicídio cometidas por homens demandam maiores cuidados durante a assistência realizada pelos bombeiros. Conclusões: O perfil das vítimas de tentativas de suicídio apresentou frequência semelhante entre homens e mulheres, sendo as mulheres mais jovens. Nas mulheres, observou-se predomínio de intoxicações. Em homens, os transtornos mentais foram mais prevalentes. Além disso, fazem-se necessários o reconhecimento precoce dos casos de tentativas de suicídio, as principais formas de atuação e o preenchimento adequado das fichas de atendimento pré-hospitalar.
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Affiliation(s)
| | | | - Alice Correia Barros
- Universidade Estadual de Ciências da Saúde de Alagoas, Brasil; Universidade Federal de Alagoas, Brasil
| | - Elaine Kristhine Rocha Monteiro
- Corpo de Bombeiros Militar de Alagoas, Brasil; Universidade Federal de Alagoas, Brasil; Fundação de Ensino Superior de Olinda, Brasil
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Covariance in diurnal patterns of suicide-related expressions on Twitter and recorded suicide deaths. Soc Sci Med 2020; 253:112960. [DOI: 10.1016/j.socscimed.2020.112960] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/29/2020] [Accepted: 03/22/2020] [Indexed: 12/21/2022]
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