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Jones AA, Hard G, Gray J, Apsley HB, Santos-Lozada AR. The Role of Substance Use Disorders on Suicidal Ideation, Planning, and Attempts: A Nationally Representative Study of Adolescents and Adults in the United States, 2020. Subst Abuse 2023; 17:11782218231216233. [PMID: 38115827 PMCID: PMC10729622 DOI: 10.1177/11782218231216233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
Few nationally representative studies examine suicidality and substance use during 2020; as such, we explored the role of substance use disorders (SUDs) on suicidality among adults and adolescents in 2020. Data were derived from N = 26,084 adult participants, representing 240 million U.S. adults weighted, and N = 5,723 adolescent participants, representing 25 million U.S. adolescents (12-17 years.). Separate logistic regressions for adults and adolescents were used to assess the association of DSM-5 SUDs, related factors, and suicidal thoughts and behaviors (ideation, planning, and attempts). In 2020, adults with SUDs were nearly 4 times more likely to seriously consider suicide (aOR = 3.94, 95% CI: 3.19, 4.86), 3 times more likely to make a suicide plan (aOR = 3.09, 95% CI: 2.25, 4.25), and nearly 4 times more likely to attempt suicide (aOR = 3.77, 95% CI: 2.29, 6.19) than adults without SUDs. Adolescents with SUDs were 4 times more likely to consider suicide (aOR = 3.69, 95% CI: 2.47, 5.51), 5 times as likely to make a suicide plan (aOR = 5.14, 95% CI: 3.25, 8.13) and to attempt suicide (aOR = 5.27, 95% CI: 2.91, 9.53) than adolescents without SUDs. Adult females and individuals experiencing poverty were twice as likely to attempt suicide than adult males and individuals not living in poverty. Adolescent females were 3-5 times more likely to seriously consider, plan, and attempt suicide than adolescent males. Interventions to curb suicidality among individuals with SUDs are crucial.
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Affiliation(s)
- Abenaa A Jones
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
- Consortium on Substance Use and Addiction, Penn State University, University Park, PA, USA
| | | | - Joy Gray
- Department of Educational Psychology, Counseling, & Special Education College of Education, Pennsylvania State University, University Park, PA, USA
| | - Hannah B Apsley
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Alexis R Santos-Lozada
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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Raddi S, Tarozzi I, Cecchetti M, Chericoni S, Franceschetti L, Bugelli V. An unusual case of a triple suicide pact at the time of the COVID-19 pandemic. J Forensic Sci 2023; 68:2194-2199. [PMID: 37565422 DOI: 10.1111/1556-4029.15358] [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: 05/14/2023] [Revised: 07/02/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
In December 2020, the World Health Organization (WHO) declared SARS-CoV2 a global pandemic. Home confinement, low social contacts, and fear of virus transmission played a major role as risk factors for suicides during the following period. Suicide pacts, in particular, showed a different pattern. A rare case of a triple suicide pact among members of the same family nucleus is presented. The victims were an elderly, severely ill woman and her adult children (a son and daughter), linked by a morbid relationship. The last time the family was seen alive was 40 days before the discovery. All corpses presented decompositional changes. After a full autopsy, the cause of death was determined to be a lethal intake of morphine for the mother and acute blood loss due to self-stabbing at the neck for the siblings. The younger woman was under the effects of a large amount of heparin. Toxicological analysis was positive for opioids and alcohol in both siblings. Suicide pacts have rarely been described during the COVID-19 pandemic. In the few cases reported, the victims were more often relatives than people in a romantic relationship. The involvement of three people is unusual, as is the use of different suicide methods among the victims. In the presented case, the elderly mother's imminent death from terminal cancer, her concern over dying in a nondomestic environment, and the siblings' fear of being alone likely led to the conception of the suicide pact. Social isolation and economic difficulties also played a contributing role.
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Affiliation(s)
- Silvia Raddi
- Health Science Department, Forensic Pathology Section, University of Florence, Florence, Italy
| | - Ilaria Tarozzi
- Department of Legal Medicine and Risk Management, Modena Local Health Unit, Modena, Italy
| | | | - Silvio Chericoni
- Forensic Toxicology Laboratory, Department of Surgical, Medical, Molecular, Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Lorenzo Franceschetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valentina Bugelli
- Department of Legal Medicine, South-East Tuscany Health Unit, Grosseto, Italy
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McCool MW, Mochrie KD, Lothes JE, Guendner E, St. John J, Noel NE. Drug use and suicidal ideation in the daily lives of individuals in a dialectical behavior therapy program. J Clin Psychol 2023; 79:2556-2565. [PMID: 37462923 PMCID: PMC10592253 DOI: 10.1002/jclp.23564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES Substance use disorders and borderline personality disorders (BPD) often co-occur and may be concurrently treated by Dialectical Behavior Therapy (DBT). However, there is limited information on how drug use and suicidal ideation may interact in the daily lives of individuals receiving DBT treatment. METHODS This study examined the DBT diary cards of 47 individuals in a community mental health center's partial hospital and intensive outpatient program. Multilevel modeling techniques were used to examine the moderating effects of BPD symptom severity on the relationship between same day, 1-, 2-, and 3-day lagged drug use and suicidal ideation. RESULTS Results indicated a significant relationship between same-day, 1-day lagged, 2-day lagged drug use and suicidal ideation. BPD was a moderator for the relationship between 1-day lagged drug use and suicidal ideation. CONCLUSION Limitations of the study include the measure for BPD symptom severity was only collected pretreatment and the results are likely limited to the effects of cannabis use on suicidal ideation. Clinicians may need to consider the prolonged effects of drug use on suicidal ideation when conducting chain analyses on suicidal behaviors.
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Affiliation(s)
- Matison W. McCool
- The Center on Alcohol, Substance Use, And Addictions, The University of New Mexico
| | | | - John E. Lothes
- University of North Carolina Wilmington
- Delta Behavioral Health
| | - Eric Guendner
- University of North Carolina Wilmington
- Delta Behavioral Health
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Rus Prelog P, Matić T, Pregelj P, Sadikov A. A pilot predictive model based on COVID-19 data to assess suicidal ideation indirectly. J Psychiatr Res 2023; 163:318-324. [PMID: 37247460 PMCID: PMC10204589 DOI: 10.1016/j.jpsychires.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/03/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023]
Abstract
The COVID-19 pandemic has had a negative impact on the mental health of the population. Many studies reported high levels of psychological distress and rising rates of suicidal ideation (SI). Data on a range of psychometric scales from 1790 respondents were collected in Slovenia through an online survey between July 2020 and January 2021. As a worrying percentage (9.7%) of respondents reported having SI within the last month, the goal of this study was to estimate the presence of SI, as indicated by the Suicidal Ideation Attributes Scale (SIDAS). The estimation was based on the change of habits, demographic features, strategies for coping with stress, and satisfaction with three most important aspects of life (relationships, finances, and housing). This could both help recognize the telltale factors indicative of SI and potentially identify people at risk. The factors were specifically selected to be discreet about suicide, likely sacrificing some accuracy in return. We tried four machine learning algorithms: binary logistic regression, random forest, XGBoost, and support vector machines. Logistic regression, random forest, and XGBoost models achieved comparable performance with the highest area under the receiver operating characteristic curve of 0.83 on previously unseen data. We found an association between various subscales of Brief-COPE and SI; Self-Blame was especially indicative of the presence of SI, followed by increase in Substance Use, low Positive Reframing, Behavioral Disengagement, dissatisfaction with relationships and lower age. The results showed that the presence of SI can be estimated with reasonable specificity and sensitivity based on the proposed indicators. This suggests that the indicators we examined have a potential to be developed into a quick screening tool that would assess suicidality indirectly, without unnecessary exposure to direct questions on suicidality. As with any screening tool, subjects identified as being at risk, should be further clinically examined.
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Affiliation(s)
- Polona Rus Prelog
- University Psychiatric Clinic Ljubljana, Centre for Clinical Psychiatry, Ljubljana, Slovenia.
| | - Teodora Matić
- Artificial Intelligence Laboratory, University of Ljubljana, Faculty of Computer and Information Science, Ljubljana, Slovenia
| | - Peter Pregelj
- University Psychiatric Clinic Ljubljana, Centre for Clinical Psychiatry, Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Aleksander Sadikov
- Artificial Intelligence Laboratory, University of Ljubljana, Faculty of Computer and Information Science, Ljubljana, Slovenia
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Shroff FMC. Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans. Front Glob Womens Health 2023; 4:1126934. [PMID: 36860346 PMCID: PMC9968936 DOI: 10.3389/fgwh.2023.1126934] [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] [Received: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.
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Affiliation(s)
- Farah Mahrukh Coomi Shroff
- Department of Family Practice and School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,Maternal and Infant Health Canada, Vancouver, BC, Canada,Correspondence: Farah Mahrukh Coomi Shroff
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