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Mehanović E, Rosso G, Cuomo GL, Diecidue R, Maina G, Costa G, Vigna-Taglianti F. Risk Factors for Suicide Reattempt among Adolescents and Young Adults: The Role of Psychiatric Disorders. Psychiatr Q 2024; 95:69-84. [PMID: 38057631 DOI: 10.1007/s11126-023-10064-5] [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] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
Suicidal behaviour among young people is a serious public health concern. Each suicide attempt is related to further suicide attempts and completed suicide. This study aims to explore risk factors associated with repeated suicide attempt among adolescents and young adults. The cohort included 510 patients aged 12-29 years residing in Piedmont Region in North-Western Italy, who had been admitted to hospital or emergency department with a diagnosis of suicide attempt between 2010 and 2020. Cox regression models were used to evaluate potential risk factors for repeated suicide attempt. During the 11-years follow-up, 20.6% of adolescents and young adults repeated suicide attempt, 24.8% of females and 12.3% of males. Nearly 90% of youth who attempted suicide had a diagnosis of psychiatric disorder. After adjustment, younger age of onset of suicidal behaviour, and diagnosis of schizophrenia, bipolar disorder, depressive disorder, anorexia nervosa and personality disorder were significantly associated with repeated suicide attempt. The early identification of patients at higher risk of repetition of suicidal behaviour is of crucial importance. Better understanding of risk factors and effective treatment of mental disorders could help suicide prevention to reduce the burden of the problem among young people. Special attention should be paid during the initial months following discharge from hospital or emergency department, when suicide reattempt risk is very high.
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Affiliation(s)
- Emina Mehanović
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy.
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy.
| | - Gianluca Rosso
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
- Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Gian Luca Cuomo
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy
| | - Roberto Diecidue
- Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy
| | - Giuseppe Maina
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
- Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
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Pigolkin YI, Gornostaev DV, Shigeev SV, Yagmurov OD, Sheptulin DA. [Forensic medical characteristic of hanging incidents among juvenile]. Sud Med Ekspert 2023; 66:9-13. [PMID: 37496475 DOI: 10.17116/sudmed2023660419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
THE AIM OF THE STUDY Was to conduct the epidemiological analysis of juveniles' deaths by hanging, registered in the Bureau of Forensic Medical Expertise, Moscow for 2017-2021 years. The number of incidents equal 61 was revealed (2.65% of whole hanging incidents for the researched period). The amount of hanging deaths among juveniles and their percent in the total quantity of deaths from this type of strangulated asphyxia increased in 2017, 2018 and 2019 years to 8 (1.6%), 15 (3.1%) and 18 (3.6%) incidents respectively; decreased in 2020 year to 7 (1.7%) incidents and increased again in 2021 year to 13 (3.0%) incidents. Juveniles died by hanging were mostly male (73.8%) aged from 15 to 18 years (63.9%). The median age for girls was 16 years (IQR 15.0-16.75) and for boys 15 years (IQR 13.0-16.5). Most of juveniles' corps were found in their place of residence: in apartments or residential houses (the whole number was 49 or 80.4%). Generally, juvenile hanging occurred between November and January (36.1% of all incidents) and in April (11.5%); less frequently were in February (1.6%), June and July (9.8%). Alcohol was found in blood of 18.2% juveniles aged from 15 to 18.
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Affiliation(s)
- Yu I Pigolkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Gornostaev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Bureau of Forensic Medical Expertise, Moscow, Russia
| | - S V Shigeev
- Bureau of Forensic Medical Expertise, Moscow, Russia
| | - O D Yagmurov
- Bureau of Forensic Medicine, St. Petersburg, Russia
| | - D A Sheptulin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Chau K, Schweitzer-Troester C, Leroy B, Kabuth B. Associations between school difficulties and family type and the role of socioeconomic, behavior and health-related difficulties in early adolescents: a population-based study. Nord J Psychiatry 2022; 76:623-633. [PMID: 35112630 DOI: 10.1080/08039488.2022.2030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Nowadays many early adolescents are living in non-intact families (parents divorced/separated, reconstructed families or single parents) and have many school difficulties (learning difficulty, skipping school, school absence due to family problems, grade repetition, low school performance, and school dropout ideation). This study assessed the associations between school difficulties and family type which remain little addressed and the confounding role of socioeconomic adversities and behavior, social support and health-related difficulties (BSSHDs). METHODS The study population included 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed at the end of school-year a questionnaire gathering socioeconomic adversities, school difficulties and BSSHDs (being obese, substances use, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt; cumulated number noted BSSHDCM). Data was analyzed using logistic regression models. RESULTS The adolescents with parents divorced/separated, reconstructed families or single parents had a much higher risk for various school difficulties than those in intact families (sex-age-adjusted odds ratios 1.60-4.70, mostly with p < 0.001). These risks were robust and remained significant (often with p < 0.01/0.001) after adjustment for socioeconomic adversities and BSSHDCM. The contributions of socioeconomic adversities plus BSSHDCM to the risks were mostly elevated (>40%, reaching 65%) while those of socioeconomic adversities alone were mostly moderate (<30%, but reaching 52%). CONCLUSIONS Family type plays a strong role in school difficulties among early adolescents, mainly due to socioeconomic adversities and BSSHDCM. Our results may help primary care providers identify at-risk adolescents and their problems and establish timely prevention and care.HighlightsLearning difficulty, school absence, grade repetition, low academic performance, and school dropout ideation are common in early adolescents.The adolescents with parents divorced/separated, reconstructed families or single parents have up to 4.7-time higher risk for these school difficulties than those in intact families.These risks are robust after adjustment for socioeconomic, behavior and health-related difficulties which explain up to 65% of the risks.School-difficulty prevention should consider family features and include early monitoring behavior and health-related difficulties in adolescents.
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Affiliation(s)
- Kénora Chau
- Département de Médecine Générale, Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.,INSERM Centre d'Investigations Cliniques Plurithématique 1433, UMR 1116, Vandoeuvre-lès-Nancy, France
| | | | - Benoît Leroy
- Département de Médecine Générale, Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Bernard Kabuth
- Faculté de Médecine, Service de Pédopsychiatrie, Hôpital d'Enfants de Nancy-Brabois, Université de Lorraine, Vandoeuvre-lès-Nancy, France
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Casant J, Helbich M. Inequalities of Suicide Mortality across Urban and Rural Areas: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2669. [PMID: 35270369 PMCID: PMC8909802 DOI: 10.3390/ijerph19052669] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023]
Abstract
Suicide mortality is a major contributor to premature death, with geographic variation in suicide rates. Why suicide rates differ across urban and rural areas has not yet been fully established. We conducted a literature review describing the urban-rural disparities in suicide mortality. Articles were searched in five databases (EMBASE, PubMed, PsychINFO, Scopus, and Web of Science) from inception till 26 May 2021. Eligible studies were narratively analyzed in terms of the urban-rural disparities in suicides, different suicide methods, and suicide trends over time. In total, 24 articles were included in our review. Most studies were ecological and cross-sectional evidence tentatively suggests higher suicide rates in rural than in urban areas. Men were more at risk by rurality than women, but suicide is in general more prevalent among men. No obvious urban-rural pattern emerged regarding suicide means or urban-rural changes over time. Potential suicidogenic explanations include social isolation, easier access to lethal means, stigmatization toward people with mental health problems, and reduced supply of mental health services. For research progress, we urge, first, individual-level cohort and case-control studies in different sociocultural settings. Second, both rurality and urbanicity are multifaceted concepts that are inadequately captured by oversimplified typologies and require detailed assessments of the sociophysical residential environment.
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Affiliation(s)
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, The Netherlands;
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Porru F, Schuring M, Bültmann U, Portoghese I, Burdorf A, Robroek SJW. Associations of university student life challenges with mental health and self-rated health: A longitudinal study with 6 months follow-up. J Affect Disord 2022; 296:250-257. [PMID: 34624809 DOI: 10.1016/j.jad.2021.09.057] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/30/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health. METHODS In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals). RESULTS Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6). DISCUSSION Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students.
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Affiliation(s)
- Fabio Porru
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, the Netherlands
| | - Igor Portoghese
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Li Z, Xiao L, Yang L, Li S, Tan L. Characterization of Acute Poisoning in Hospitalized Children in Southwest China. Front Pediatr 2021; 9:727900. [PMID: 34956970 PMCID: PMC8705540 DOI: 10.3389/fped.2021.727900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/08/2021] [Indexed: 01/17/2023] Open
Abstract
Objective: Acute poisoning in children is characterized by regional differences. This study described the basic situation of childhood poisoning in southwest China based on hospitalized cases. Data and Methods: A total of 1,076 acute poisoning cases among hospitalized children admitted to Children's Hospital of Chongqing Medical University from January 2012 to December 2020 were included in this study. Clinical data such as gender, age, living environment, poisonous substance, and cause of poisoning were statistically described. Trends of length of hospital stay, population distribution, poisonous substances, and causes of acute poisoning in the hospitalized children were compared over time. Results: The cohort comprised 588 males and 488 females; 811 cases lived in rural areas and the rest resided in urban areas. Most cases were between early childhood and school age. Poisoning usually occurred at home (973 cases, 90.4%). Pesticides (381 cases, 35.4%) and drugs (275 cases, 25.6%) were the two most common poisonous substances. Two main causes of poisoning were accidental taking (755 cases, 70.2%) and suicide (177 cases, 16.4%). The results of univariate analysis of suicide showed significant correlations among gender, place of residence, age, poisonous substance, and place of suicide (P < 0.001), while living environment (town), age (adolescence), and poisonous substance (pesticide, drug) were independent risk factors (P < 0.05). There was no significant change in the length of hospital stay for poisoning over time. The overall number of hospitalizations presented a decreasing trend, while the number of urban children gradually increased. The proportion of adolescent poisoned children and suicidal children increased in the last 3 years. Conclusion: Optimizing the package and distribution channels of pesticides and drugs, raising safety awareness of children to avoid accidental injuries, and paying attention to children's mental health are measures that are necessary to prevent poisoning in children.
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Affiliation(s)
- Zhu Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Xiao
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shaojun Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Liping Tan
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Department of Emergency, Children's Hospital of Chongqing Medical University, Chongqing, China
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