1
|
Thomas R, Sellers A, Fierstein JL, Cavitt M, Alvaro J, Goldenberg N. Suicide, Stimulants, and Selective Serotonin Reuptake Inhibitors: A Retrospective Chart Review. J Child Adolesc Psychopharmacol 2024; 34:89-94. [PMID: 38483960 DOI: 10.1089/cap.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background: Previous studies suggest that selective serotonin reuptake inhibitors (SSRIs) may increase the risk of suicide among children and youth, although the association between suicide risk and the combination of SSRIs with other medication such as stimulants in this population remains unclear. This study explored whether the combination of SSRIs with stimulants influenced suicide risk. Methods: A retrospective cohort study was conducted at a single children's hospital campus-based ambulatory psychiatric clinic between September 1, 2017, and September 30, 2020. Subjects were 6-21 years of age and prescribed either stimulants or stimulants and SSRIs only. The primary outcome was suicidal thoughts and behaviors (STB), defined by documented suicidal thoughts, plans, or behaviors. Firth logistic regression evaluated associations between medication class and STB. Results: Among 349 patients, the prevalence of STB was 5.7% (n = 20). In unadjusted model, patients prescribed SSRIs and stimulants had a 2.9-fold increase of STB compared to patients prescribed stimulants only, along with increasing age, male sex, and the diagnoses of anxiety and/or depression. In the final model adjusted for each of these factors, the observed association of medication regiment with STB was attenuated (odds ratio [OR]: 1.3, confidence interval [CI]: 0.3-4.9, p = 0.7). The magnitude of the adjusted association between depressive diagnosis and STB was notable (OR: 3.6, CI: 1.0-12.6, p = 0.049). Conclusions: Among patients followed in a children's hospital-based ambulatory psychiatric clinic, a combination medication regimen of SSRIs and stimulants after adjusting for genetic sex, age, anxiety diagnosis, and depression diagnosis, the observed association between STB and combination stimulant and SSRI treatment was attenuated. This finding suggests that other factors, including depression, may have contributed to the association between SSRI treatment and STB. Larger, prospective studies of the relationship between combination pharmacotherapy and suicide risk are warranted to guide clinical/pharmacological decision making and to better clarify these relationships.
Collapse
Affiliation(s)
- Reena Thomas
- Department of Child and Adolescent Psychiatry, RĀZ MINDS, Tampa, Florida, USA
| | - Austin Sellers
- Department of Pediatrics, Office of Graduate Medical Education, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Clinical Research Operations Shared Resource, Johns Hopkins All Children's Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Jamie L Fierstein
- Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Epidemiology and Biostatistics Shared Resource, Johns Hopkins All Children's Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Mark Cavitt
- Department of Child and Adolescent Psychiatry, Johns Hopkins All Childrens Hospital, St. Petersburg, Florida, USA
- Afflicates of University of South Florida School of Medicine Child and Adolescent Psychiatry Department, Tampa, Florida, USA
| | - Jeffrey Alvaro
- Department of Child and Adolescent Psychiatry, Johns Hopkins All Childrens Hospital, St. Petersburg, Florida, USA
- Afflicates of University of South Florida School of Medicine Child and Adolescent Psychiatry Department, Tampa, Florida, USA
| | - Neil Goldenberg
- Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Clinical Research Operations Shared Resource, Johns Hopkins All Children's Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
- Department of Pediatrics, and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
2
|
Brown K, Bez Y, Truong K, Saaraswat M, Coffey BJ. Understanding and Managing New Onset Homicidal Ideation in an Adolescent with Depression. J Child Adolesc Psychopharmacol 2023; 33:393-397. [PMID: 37966361 DOI: 10.1089/cap.2023.29250.bjc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- Keneil Brown
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA
| | - Yasin Bez
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA
| | - Kathy Truong
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA
| | - Manya Saaraswat
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA
| | - Barbara J Coffey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, Jackson Behavioral Health Hospital, Miami, Florida, USA
| |
Collapse
|
3
|
Pikala M, Burzyńska M. The Burden of Suicide Mortality in Poland: A 20-Year Register-Based Study (2000-2019). Int J Public Health 2023; 68:1605621. [PMID: 36816833 PMCID: PMC9931732 DOI: 10.3389/ijph.2023.1605621] [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: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
Objectives: The aim of the study was to assess mortality trends due to suicide in Poland in the years 2000-2019 with the use of joinpoint regression. Methods: The study analysed all suicide deaths in Poland in the years 2000-2019 (N = 113,355). Age-standardised death rates (SDRs), the annual percentage change (APC) and the average annual percentage change (AAPC) were determined. Results: In the male group, SDR was 29.3 in 2000 and 21.6 in 2019, in the female group, SDR decreased from 5.2 to 3.0. In 2019, the highest SDR values were noted in the group aged between 45 and 64 years. The most common method of suicide was hanging. In 2019, odds ratios (OR) of death due to suicide for age groups 15-24 years vs. 65 years or above were 51.47 among men and 181.89 among women. With regards to primary vs. tertiary education, OR values were 1.08 and 0.25, respectively; for single vs. widowed individuals 8.22 and 12.35; while for rural vs. urban residents 1.60 and 1.15. Conclusion: There is a need to implement educational programmes, primarily designed for young people.
Collapse
Affiliation(s)
- Małgorzata Pikala
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine, Medical University of Lodz, Łódź, Poland
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine, Medical University of Lodz, Łódź, Poland
| |
Collapse
|
4
|
Lannoy S, Mars B, Heron J, Edwards AC. Suicidal ideation during adolescence: The roles of aggregate genetic liability for suicide attempts and negative life events in the past year. J Child Psychol Psychiatry 2022; 63:1164-1173. [PMID: 35766310 PMCID: PMC9912194 DOI: 10.1111/jcpp.13653] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STB) constitute a central public health concern in adolescence. Previous studies emphasized the difficulty to cope with negative life events during adolescence as a risk factor for STB. Familial and genetic liability has also been documented to explain STB risk. Nevertheless, less is known about aggregate genetic liability and its possible interaction with negative life events. Moreover, information is needed to understand how these factors differently affect STB in boys and girls. METHODS We evaluated suicidal ideation at 17 years old and examined the role of aggregate genetic liability, negative life events, and their interaction in a sample of 2,571 adolescents. Aggregate genetic liability was measured using a polygenic score (PGS) for suicide attempts. Negative life events were assessed in the past year and included parental divorce and hospitalizations, death of friends and relatives, bullying, failure-related events, and involvement with drugs. We conducted univariable and multivariable general linear models stratified by sex and evaluated the interactions between PGS and negative life events in subsequent models. RESULTS Analyses showed that suicidal ideation in boys is associated with failure to achieve something important (estimate = 0.198), bullying (estimate = 0.285), drug use (estimate = 0.325), and parental death (estimate = 0.923). In girls, both aggregate genetic liability (estimate = 0.041) and negative life events (failure at school [estimate = 0.120], failure to achieve something important [estimate = 0.279], drug use [estimate = 0.395], and bullying [estimate = 0.472]) were associated with suicidal ideation. Interaction analyses suggested that PGS interacted with drug use and failures at school, though this would need additional support. CONCLUSIONS These findings represent significant contributions to the fundamental understanding of STB in adolescence, suggesting to monitor the impact of negative life events during adolescence to better prevent suicide risk. Genetic liability is also of importance in girls and might influence the way they respond to environmental threats.
Collapse
Affiliation(s)
- Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth University School of MedicineRichmondVAUSA
| | - Becky Mars
- Population Health SciencesUniversity of BristolBristolUK
| | - Jon Heron
- Population Health SciencesUniversity of BristolBristolUK
| | - Alexis C. Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth University School of MedicineRichmondVAUSA
| |
Collapse
|
5
|
Kabir H, Maple M, Islam MS, Usher K. Prevalence of Suicide Thoughts and Behaviours among Female Garment Workers Who Survived the Rana Plaza Collapse: An In-Depth Inquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6326. [PMID: 34207986 PMCID: PMC8296151 DOI: 10.3390/ijerph18126326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
The Rana Plaza building collapse occurred on 24 April 2013 in Savar, near the capital city of Bangladesh, killing more than 1130 garment workers and injured about 2500, mostly females. Those who survived face ongoing challenges, including socio-cultural constraints, economic hardship, post-traumatic stress disorders (PTSD), depression, and critical health issues, which may lead to suicidal ideation and death. The aim of this article is to explore why and how female garment workers who survived the Rana Plaza collapse are now at risk of suicide thoughts and behaviours, and suicide death. Unstructured face-to-face interviews were held from April to July 2018 with 11 female garment workers who survived the Rana Plaza building collapse. Interviews continued until data saturation was reached. The interviews were tape-recorded and transcribed verbatim while simultaneously being translated into English from Bengali/Bangla. Transcripts were coded and thematically analysed. The study found that all participants were living with multiple risk factors of suicidal ideation (including low socio-economic status, poverty, social stigma, psychological distress, and trauma) which the participants directly linked to the collapse of the Rana Plaza building. Our analysis uses the three-step theory of suicide (3ST, Klonsky & May, 2015) to understand female Rana Plaza survivors' suicide risk. Female survivors' overall vulnerability requires urgent attention while taking the socio-cultural setting of Bangladesh into account. In addition, a lifelong caring system (combining financial security and free healthcare) needs to be initiated to accommodate the female survivors with mainstream society to avoid possible future suicides. They require long-term social and economic security and psychological support.
Collapse
Affiliation(s)
- Humayun Kabir
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
- Department of Sociology, University of Dhaka, Dhaka 1000, Bangladesh
| | - Myfanwy Maple
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
| |
Collapse
|
6
|
Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community. Eur Child Adolesc Psychiatry 2021; 30:937-951. [PMID: 32572615 PMCID: PMC8140957 DOI: 10.1007/s00787-020-01573-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/08/2020] [Indexed: 01/26/2023]
Abstract
Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare. Self-injury in males and sex differences are poorly understood. This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury. Data came from a Swiss prospective-longitudinal cohort study (N = 1482). Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20. Between ages 13-20, 27% of adolescents reported self-injury at least once. In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20). In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] < 3 to OR > 10); in females, recurrence was high from age 13 onwards (OR > 5). Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset. Typically, less than half of adolescents with self-injury used mental health services. Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization. Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization. There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use. Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury. Males are at particular risk of not receiving adequate treatment for self-injury.
Collapse
|
7
|
Abstract
The aim of this study was to compare sleep problems among adolescents who attempted suicide and healthy adolescents who never attempted suicide. Adolescents who attempted suicide (study group, n = 103) and healthy adolescents (control group, n = 59) completed a questionnaire prepared by researchers including demographic factors. In addition, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were administered to both groups. The median age was 16 years and 73% were girls, in both groups. The study group had lower rate of attending to school (88.3% vs. 100%; p = 0.001), academic achievement (45.7% vs. 83.1%; p = 0.001), higher rate of smoking (37.9% vs. 13.8%; p = 0.001), socializing problems (31.1% vs. 3.4%; p = 0.001), and appetite changes (57.3% vs. 39.7%; p = 0.032) than controls. The rate of those with PSQI scores 6 or higher was 53.4% in the attempted suicide group and 37.3% in the control group (p = 0.048). Adolescents, classified as sleepy according to the ESS, did not differ significantly between the groups (p = 0.214). Adolescents who attempted suicide had poor sleep quality. It is crucial to examine the kinds of sleep problems adolescents who have attempted suicide have experienced. Among adolescents attending outpatient clinics with poor sleep quality, PSQI can be a useful screening tool. Those with high scores should be evaluated for suicide risk.
Collapse
|
8
|
Dean-Boucher A, Robillard CL, Turner BJ. Chronic medical conditions and suicidal behaviors in a nationally representative sample of American adolescents. Soc Psychiatry Psychiatr Epidemiol 2020; 55:329-337. [PMID: 31515583 DOI: 10.1007/s00127-019-01770-2] [Citation(s) in RCA: 9] [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: 05/21/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Chronic medical conditions are a risk factor for the onset of suicidal thoughts and behaviors in adults. However, few studies have examined this association in adolescents. The present study explored the association between chronic medical conditions and the emergence of suicidal thoughts and behaviors in an adolescent sample representative of the U.S.A. METHOD Using data from the National Comorbidity Survey-Adolescent Supplement (10,148 Americans between ages 13-17), discrete-time survival analyses were performed to examine the odds of developing suicidal ideation, planning, and attempts, given prior presence of a chronic medical condition. Multivariate models controlled for sociodemographic factors and the presence of comorbid mental health conditions. Post-hoc sensitivity analyses examined associations between timing of chronic medical condition onset and later suicidal thoughts and behaviors. RESULTS Multivariate analyses showed that dermatological conditions, asthma, allergies, headache, and back/neck pain were associated with elevated odds of suicidal ideation, while cardiovascular conditions were associated with increased odds of suicide attempts. Additionally, cardiovascular conditions were associated with increased risk of suicide planning and attempts among adolescents with suicidal ideation. Chronic medical conditions that began in adolescence were associated with the greatest risk of later suicidal thoughts and behaviors, compared to chronic medical conditions that began in early or middle childhood. CONCLUSION Consistent with research in middle and older adults, physical health conditions are associated with increased risk for the onset of suicidal thoughts and behaviors in adolescents. Mental health screening for adolescents with chronic medical conditions may help parents and physicians identify suicidality early.
Collapse
Affiliation(s)
- Anthony Dean-Boucher
- Department of Psychology, University of Victoria, P. O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Christina L Robillard
- Department of Psychology, University of Victoria, P. O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, P. O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
| |
Collapse
|
9
|
Akkaya-Kalayci T, Vyssoki B, Winkler D, Willeit M, Kapusta ND, Dorffner G, Özlü-Erkilic Z. The effect of seasonal changes and climatic factors on suicide attempts of young people. BMC Psychiatry 2017; 17:365. [PMID: 29141599 PMCID: PMC5688742 DOI: 10.1186/s12888-017-1532-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/07/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall can influence suicidal behavior. METHODS This study analyses the relationship between seasonal changes and climatic variations and suicide attempts in 2131 young patients in Istanbul, Turkey. RESULTS In our study sample, there was an association between suicide attempts in youths and seasonal changes, as suicide attempts occurred most frequently during summer in females as well as in males. Furthermore, there was a positive correlation between the mean temperature over the past 10 days and temperature at the index day and suicide attempts in females. After seasonality effects were mathematically removed, the mean temperature 10 days before a suicide attempt remained significant in males only, indicating a possible short-term influence of temperature on suicide attempts. CONCLUSIONS This study shows an association between suicide attempts of young people and climatic changes, in particular temperature changes as well as seasonal changes. Therefore, the influence of seasonal changes and climatic factors on young suicide attempters should get more attention in research to understand the biopsychosocial mechanisms playing a role in suicide attempts of young people. As suicide attempts most frequently occur in young people, further research is of considerable clinical importance.
Collapse
Affiliation(s)
- Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Benjamin Vyssoki
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Dietmar Winkler
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Matthaeus Willeit
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Nestor D. Kapusta
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Georg Dorffner
- 0000 0000 9259 8492grid.22937.3dSection of Artificial Intelligence, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Freyung 6/2, 1010 Vienna, Austria
| | - Zeliha Özlü-Erkilic
- Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
10
|
Akkaya-Kalayci T, Kapusta ND, Waldhör T, Blüml V, Poustka L, Özlü-Erkilic Z. The association of monthly, diurnal and circadian variations with suicide attempts by young people. Child Adolesc Psychiatry Ment Health 2017; 11:35. [PMID: 28781609 PMCID: PMC5537930 DOI: 10.1186/s13034-017-0171-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 06/18/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that there may be an association between monthly, diurnal and circadian changes and suicidal behaviours. METHODS In the present study we analysed retrospectively records of 2232 youth, who were treated in emergency units of state hospitals in Istanbul/Turkey after attempting suicide. RESULTS The majority of the suicide attempters were females (81.6%). In both sexes, suicide attempts most frequently occurred at the beginning of the calendar week and between evening and midnight. CONCLUSIONS This study shows that suicide attempts in youth follow diurnal and circadian changes. As suicide attempts of youth most frequently occurred at the beginning of the calendar week and between evening and midnight, health services such as specialized counselling for youth should especially be available during this time.
Collapse
Affiliation(s)
- Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Nestor D. Kapusta
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Thomas Waldhör
- 0000 0000 9259 8492grid.22937.3dDepartment for Epidemiology, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
| | - Victor Blüml
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Luise Poustka
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Zeliha Özlü-Erkilic
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| |
Collapse
|
11
|
Bolat N, Kadak T, Eliacik K, Sargin E, Incekas S, Gunes H. Maternal and paternal personality profiles of adolescent suicide attempters. Psychiatry Res 2017; 248:77-82. [PMID: 28024181 DOI: 10.1016/j.psychres.2016.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/08/2016] [Accepted: 12/13/2016] [Indexed: 12/20/2022]
Abstract
Personality features have been correlated with suicidal behaviors in recent decades. Given its neurobiological background, Cloninger's model of personality, the Temperament and Character Inventory (TCI), may help to identify the maternal and paternal personality dimensions associated with adolescent suicide attempts. The present study is the first that specifically compares the temperament and character profiles of both mothers and fathers of the adolescent suicide attempters with a control group, by considering the influence of demographic and clinical factors. The study group comprised 117 parents of 71 adolescent suicide attempters and 119 parents of 71 age- and gender-matched adolescents without a suicide attempt included as a control group. The TCI and Brief Symptom Inventory (BSI) were applied to the parents in both groups. Logistic regression analysis, which was performed to adjust confounding factors, demonstrated significantly higher scores for harm avoidance among the mothers and lower scores of self-directedness among the fathers of the adolescent suicide attempters. New psychotherapeutic modalities considering the high-risk parental personality traits would be beneficial to support parent-adolescent relationships and may have a preventative effect on adolescent suicide.
Collapse
Affiliation(s)
- Nurullah Bolat
- Department of Child and Adolescent Psychiatry, Tepecik Teaching and Research Hospital, Izmir, Turkey.
| | - Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Istanbul University Cerrahpasa Medical Faculty, İstanbul, Turkey
| | - Kayi Eliacik
- Department of Pediatrics, Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Enis Sargin
- Department of Child and Adolescent Psychiatry, Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Secil Incekas
- Department of Child and Adolescent Psychiatry, Dortcelik Children Hospital, Bursa, Turkey
| | - Hatice Gunes
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| |
Collapse
|
12
|
Gokalp G, Anil M, Bal A, Bicilioglu Y, Kamit Can F, Anil AB. Factors affecting the decision to hospitalise children admitted to the emergency department due to non-fatal suicide attempts by pills. Pak J Med Sci 2016; 32:731-5. [PMID: 27375723 PMCID: PMC4928432 DOI: 10.12669/pjms.323.9765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: Suicide attempts (SAs) in the paediatric age group represent an important cause of morbidity and mortality. Our aim was to examine the factors affecting the decision to hospitalize children with a diagnosis of non-fatal SA by pills. Methods: Children <18 years of age admitted with SA by pills during 2014 were evaluated retrospectively. Patients were divided into two groups: Group-I comprised hospitalised patients and Group-II included those who were discharged from the PED. These two groups were compared in terms of clinical and demographic characteristics recorded upon PED admission. Results: A total of 196 patients were included in the study. The number of pills taken for self-poisoning in Group-I (median: 20 pills) was higher than that in Group-II (median: 12 pills) (p < 0.001), and the rate of pathological findings during the first paediatric psychiatric consultation was higher in Group-I (91.1%) than in the Group-II (54.8%) (p < 0.001). Conclusion: Factors affecting the disposition decision in cases of children who performed non-fatal SA via pills included the amount of medication taken for the suicide attempt and the presence of psychiatric disorders, as determined by a paediatric psychiatrist during the acute phase.
Collapse
Affiliation(s)
- Gamze Gokalp
- Gamze Gokalp, MD. Pediatric Emergency Department, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Murat Anil
- Murat Anil, MD. Associate Professor, Pediatric Emergency Department, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Alkan Bal
- Alkan Bal, MD. Pediatric Emergency Department, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Yuksel Bicilioglu
- Yuksel Bicilioglu, MD. Pediatric Emergency Department, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Fulya Kamit Can
- Fulya Kamit Can, MD. Pediatric Intensive Care Clinic, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| | - Ayse Berna Anil
- Ayse Berna Anil, MD. Associate Professor, Pediatric Intensive Care Unit, Pediatric Intensive Care Clinic of Izmir Katip Celebi University, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey
| |
Collapse
|
13
|
Margarit Soler A, Martínez Sanchez L, Martínez Monseny A, Trenchs Sainz de la Maza V, Picouto González MD, Villar Cabeza F, Luaces Cubells C. Características epidemiológicas de las tentativas de suicidio en adolescentes atendidos en Urgencias. An Pediatr (Barc) 2016; 85:13-7. [DOI: 10.1016/j.anpedi.2015.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 04/22/2015] [Accepted: 04/29/2015] [Indexed: 11/26/2022] Open
|
14
|
Margarit Soler A, Martínez Sanchez L, Martínez Monseny A, Trenchs Sainz de la Maza V, Picouto González MD, Villar Cabeza F, Luaces Cubells C. Epidemiological characteristics in suicidal adolescents seen in the emergency department. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
15
|
Jia CX, Li SB, Han M, Bo QG. Health-Related Factors and Suicidal Ideation in High School Students in Rural China. OMEGA-JOURNAL OF DEATH AND DYING 2015. [DOI: 10.1177/0030222815576126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study aimed to understand the reporting rate of suicidal ideation and its health-related factors in 1,378 high school students in rural China. These students were recruited from two high schools in Lijin County, Shandong Province, China by using a stratified random cluster sampling method. Overall, 13.5% of the sample reported having suicidal ideation in the past year, and there was no significant difference between boys and girls in reporting rate of suicidal ideation. Nightmares, physical activity, and sleep duration as well as family environment, paternal education, and mental heath status were significantly associated with suicidal ideation. More efforts for these factors should be considered in suicide prevention for high school students in rural China.
Collapse
Affiliation(s)
- Cun-Xian Jia
- Shandong University School of Public Health, China
- Shandong University Center for Suicide Prevention Research, China
| | - Shi-Bao Li
- Shandong University School of Public Health, China
| | - Mei Han
- Qingdao Municipal Women and Children’s Hospital, Shandong, China
| | - Qi-Gui Bo
- Centers of Disease Control and Prevention of Lijin County, Shandong, China
| |
Collapse
|
16
|
Kavalci G, Ethemoglu FB, Batuman A, Kumral D, Emre C, Surgit M, Akdikan A, Kavalci C. Epidemiological and cost analysis of self-poisoning cases in ankara, Turkey. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e10856. [PMID: 25763203 PMCID: PMC4329943 DOI: 10.5812/ircmj.10856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 11/22/2013] [Accepted: 10/01/2014] [Indexed: 11/23/2022]
Abstract
Background: Poisoning is a global public health problem. Self-poisoning has potentially serious consequences. Follow-up studies have found that 3-10% of self-harm patients eventually succeed. Objectives: This study was designed to investigate the epidemiological, clinical and economical aspects of deliberate self-poisoning patients admitted to Yenimahalle State Hospital Intensive Care Unit. Patients and Methods: The study was carried out retrospectively in Ankara Yenimahalle State Hospital. It included Seventy-one patients over 16 years of age who were admitted to the hospital due to poisoning during 2012. Exposed poisons were classified into one of three categories; pharmaceuticals, pesticides, and alcohols. Cost account was based on the medical invoices at patient discharge. Data were compared using Student’s T test and chi-square test. A P value of less than 0.05 was considered significant. Results: The female/male ratio was 2.55. The mean age of the 71 poisoned patients was 28.92 ± 11.51 years. Most of the poisoning agents were pharmaceuticals (68 cases). Among the pharmaceuticals, antidepressants were involved most often, followed by analgesics. There was no statistically significant difference between pharmaceutical agents in terms of hospital cost (P > 0.05). The mean length of hospital stay was 6.4 ± 4.3 days. There was a statistically significant difference between the lengths of stay of patients in terms of hospital cost (P < 0.05). Conclusions: The patient cost increased as the length of stay increased due to the policy of bundle pricing.
Collapse
Affiliation(s)
- Gulsum Kavalci
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
- Corresponding Author: Gulsum Kavalci, Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey. Tel: +90-3125085026, Fax: +90-3123125346, E-mail:
| | - Filiz Banu Ethemoglu
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Asli Batuman
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Dilber Kumral
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Cengizhan Emre
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Meltem Surgit
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Alev Akdikan
- Department of Anesthesiology and Reanimation, Yenimahalle State Hospital, Ankara, Turkey
| | - Cemil Kavalci
- Department of Medicine Emergency, University of Baskent, Ankara, Turkey
| |
Collapse
|
17
|
Taussig HN, Harpin SB, Maguire SA. Suicidality among preadolescent maltreated children in foster care. CHILD MALTREATMENT 2014; 19:17-26. [PMID: 24567247 PMCID: PMC4319651 DOI: 10.1177/1077559514525503] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study sought to determine the prevalence of suicidal ideation, plans, and attempts among 515 preadolescent (aged 9-11 years) maltreated children who entered foster care within the prior year. Over a quarter (26.4%) of the children had a history of suicidality according to their own and/or their caregiver's report, 4.1% of whom were imminently suicidal. In bivariate analyses, children at higher risk of suicidality tended to be younger, non-Hispanic, abused, and to have experienced multiple types of maltreatment, more referrals to child welfare, more household transitions, and a longer length of time in foster care. There were no gender differences. Multiple regression analyses found physical abuse and chronicity of maltreatment to be the most robust predictors of suicidality. It is critically important that these high-risk children are screened for suicidality before adolescence and that caregivers and professionals are informed of their risk status so that they may implement mental health treatment, monitoring, and harm reduction measures.
Collapse
Affiliation(s)
- Heather N Taussig
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, Denver, CO, USA
| | | | | |
Collapse
|
18
|
Merikanto I, Lahti T, Puusniekka R, Partonen T. Late bedtimes weaken school performance and predispose adolescents to health hazards. Sleep Med 2013; 14:1105-11. [DOI: 10.1016/j.sleep.2013.06.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 06/11/2013] [Accepted: 06/15/2013] [Indexed: 12/17/2022]
|
19
|
Pelizzo G, Nakib G, Veggiotti P, Savasta S, Raffaele A, Calcaterra V. Suicide attempt in pre-pubertal age. What quality of life in a child with incurable disease? Child Care Health Dev 2013; 39:908-9. [PMID: 23594108 DOI: 10.1111/cch.12067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Pelizzo
- Department of Pediatric Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | | | | | | | | | | |
Collapse
|
20
|
Karbeyaz K, Akkaya H, Balci Y. Analysis of suicide deaths in a 15-year period in Eskisehir, western Anatolia, Turkey and the determination of risk factors. Ann Saudi Med 2013; 33:377-82. [PMID: 24060718 PMCID: PMC6078503 DOI: 10.5144/0256-4947.2013.377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES It is estimated that every year 1 million people die all around the world due to suicide. The average rate of suicide in the world is reported as 16/100,000. In this study, we aimed to evaluate and discuss the suicide cases in our city Eskisehir that is located in western Anatolia. DESIGN AND SETTINGS This is a retrospective study covering the period 1997-2011. METHODS All deaths in Eskisehir caused due to the consumption of forensic medicines in a 15-year period between 1997 and 2011 were evaluated retrospectively. A total of 553 cases were determined to be suicidal following both forensic and criminal investigations, and were included in the study. Furthermore, death examination and autopsy reports were investigated, and judicial investigation records were also taken into account. RESULTS In this period, the average rate of suicide in our city was determined as 5.1/100,000 of which 71.4% of the cases were male. It was determined that the suicides most commonly occurred between the ages of 19 and 29 (32.4%, n=179). The most commonly encountered suicide method was hanging (60.9%, n=337). CONCLUSION It was ascertained that the suicide rate in our city was lower than the average rate in the world, but it was higher than the average rate in Turkey. Unemployment was determined as the most common risk factor in our study. A follow-up should be provided for people with a history of attempting to commit suicide or with a tendency to committing suicide due to a psychological disorder.
Collapse
Affiliation(s)
- Kenan Karbeyaz
- Dr. Kenan Karbeyaz, Social Medicine, Public Health, Geriatrics,, Council of Forensic Medicine, Eskisehir Branch Manager, Eskisehir Adalet Sarayi Adli Tip Sube Muduriugu, Eskisehir 26100 Turkey, T: +90-505-223-0885, F: +90-222-240-71119,
| | | | | |
Collapse
|
21
|
Ragolsky M, Shimon H, Shalev H, Weizman A, Rubin E. Suicidal thoughts are associated with platelet counts in adolescent inpatients. J Child Adolesc Psychopharmacol 2013; 23:49-53. [PMID: 23410141 DOI: 10.1089/cap.2012.0057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Platelets (PLT), which serve as the primary hemostatic indicator, can be used as a peripheral model for studying monoamine turnover in the brain. Therefore, they are attractive targets as circulatory biomarkers for the detection of psychiatric disorders. However, PLT counts have not been utilized as a peripheral biomarker of psychopathology. METHODS This study was a retrospective analysis of PLT counts upon admission of 108drug-naïve adolescents hospitalized in an inpatient psychiatric department. PLT counts of patients with suicidal ideation (SI) were compared with those of nonsuicidal in patients (NSI) and those of 77 healthy adolescents, serving as a control group. The patients' disorders were diagnosed and classified by one of four American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM IV) diagnoses, that is, unipolar depression, bipolar depression, schizophrenia, and a pooled group of conduct and borderline personality disorders. RESULTS Significantly higher PLT counts were observed in SI patients, as compared with NSI patients (300,200±53.3/mL vs. 253,900±53.2/mL, respectively; p=0.0001). A significant difference in PLT counts in SI patients, relative to the control group, was also noted (300,200±53.3/mL vs. 254,000±52/mL, respectively; p=<10(-26)). Finally, a significant difference in PLT counts was observed between conduct/borderline personality disorders patient with and without suicidal ideation (292,000±55/mL vs. 246,000±64/mL, respectively; p=0.001). CONCLUSIONS PLT counts are higher in suicidal hospitalized adolescents than in nonsuicidal inpatients, as well as than in controls.
Collapse
Affiliation(s)
- Micha Ragolsky
- The Beer-Sheva Mental Health Center, Beer-Sheva, Israel.
| | | | | | | | | |
Collapse
|
22
|
Low NCP, Dugas E, Constantin E, Karp I, Rodriguez D, O’Loughlin J. The association between parental history of diagnosed mood/anxiety disorders and psychiatric symptoms and disorders in young adult offspring. BMC Psychiatry 2012; 12:188. [PMID: 23126640 PMCID: PMC3534519 DOI: 10.1186/1471-244x-12-188] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 10/27/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Parental history of mood or anxiety disorders is one of the strongest and most consistent risk factors for the development of these disorders in offspring. Gaps remain however in our knowledge of whether maternal or paternal disorders are more strongly associated with offspring disorders, and whether the association exists in non-clinical samples. This study uses a large population-based sample to test if maternal or paternal history of mood and/or anxiety disorders increases the risk of mood and/or anxiety disorders, or symptoms of specific anxiety disorders, in offspring. METHODS Data were drawn from the Nicotine Dependence in Teens Study, a prospective cohort investigation of 1293 grade 7 students. Data on mental health outcomes were collected in mailed self-report questionnaires when participants were aged 20.4 (0.7) years on average. Parental data were collected in mailed self-report questionnaires. This current analysis pertains to 564 participants with maternal and/or paternal data. The association between maternal and paternal history and each of diagnosed anxiety disorder, diagnosed mood disorder, and symptoms of specific anxiety disorders in offspring was studied in multivariate logistic regression. RESULTS A higher proportion of mothers than fathers had a diagnosed mood/anxiety disorder (23% versus 12%). Similarly, 14% of female offspring had a diagnosed mood/anxiety disorder, compared to 6% of male offspring. The adjusted odds ratio (95% confidence interval) for maternal history was 2.2 (1.1, 4.5) for diagnosed mood disorders, 4.0 (2.1, 7.8) for diagnosed anxiety disorders, and 2.2 (1.2, 4.0) for social phobia symptoms. Paternal history was not associated with any of the mental health outcomes in offspring. CONCLUSION Maternal, but not paternal mood/anxiety disorders were associated with diagnosed psychiatric disorders, as well as symptoms of specific anxiety disorders, in offspring. Efforts to detect mood and anxiety disorders in offspring with a maternal history should be encouraged.
Collapse
Affiliation(s)
- Nancy CP Low
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montréal, QC, H3A 1A1, Canada
| | - Erika Dugas
- Centre de Recherche de Centre Hospitalier de l’Université de Montréal, 3875 Saint Urbain, Montréal, QC, H2W 1V1, Canada
| | - Evelyn Constantin
- Department of Pediatrics, McGill University, Montreal Children’s Hospital, 2300 Tupper Street, Room C-538E, Montréal, QC, H3H 1P3, Canada
| | - Igor Karp
- Centre de Recherche de Centre Hospitalier de l’Université de Montréal, 3875 Saint Urbain, Montréal, QC, H2W 1V1, Canada,Department of Social and Preventive Medicine, University of Montréal, 7171 Parc Avenue, Montréal, QC, Canada
| | - Daniel Rodriguez
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Jennifer O’Loughlin
- Centre de Recherche de Centre Hospitalier de l’Université de Montréal, 3875 Saint Urbain, Montréal, QC, H2W 1V1, Canada,Department of Social and Preventive Medicine, University of Montréal, 7171 Parc Avenue, Montréal, QC, Canada,Institut national de santé publique du Québec, 190 Crémazie Blvd. East, Montréal, QC, H2P 1E2, Canada
| |
Collapse
|
23
|
Freuchen A, Kjelsberg E, Grøholt B. Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents. Child Adolesc Psychiatry Ment Health 2012; 6:30. [PMID: 22971572 PMCID: PMC3526543 DOI: 10.1186/1753-2000-6-30] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 09/03/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. METHOD We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death. RESULTS The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. CONCLUSION In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.
Collapse
Affiliation(s)
- Anne Freuchen
- Department of Psychiatry, Faculty of Medicine, University of Oslo, N-0316, Oslo, Norway.
| | - Ellen Kjelsberg
- Centre for Forensic Psychiatry, Oslo University Hospital, N-0407, Oslo, Norway
| | - Berit Grøholt
- Institute of clinical medicine, Faculty of medicine, University of Oslo, N-0361, Oslo, Norway
| |
Collapse
|
24
|
Sequeira A, Morgan L, Walsh DM, Cartagena PM, Choudary P, Li J, Schatzberg AF, Watson SJ, Akil H, Myers RM, Jones EG, Bunney WE, Vawter MP. Gene expression changes in the prefrontal cortex, anterior cingulate cortex and nucleus accumbens of mood disorders subjects that committed suicide. PLoS One 2012; 7:e35367. [PMID: 22558144 PMCID: PMC3340369 DOI: 10.1371/journal.pone.0035367] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 03/15/2012] [Indexed: 12/23/2022] Open
Abstract
Suicidal behaviors are frequent in mood disorders patients but only a subset of them ever complete suicide. Understanding predisposing factors for suicidal behaviors in high risk populations is of major importance for the prevention and treatment of suicidal behaviors. The objective of this project was to investigate gene expression changes associated with suicide in brains of mood disorder patients by microarrays (Affymetrix HG-U133 Plus2.0) in the dorsolateral prefrontal cortex (DLPFC: 6 Non-suicides, 15 suicides), the anterior cingulate cortex (ACC: 6NS, 9S) and the nucleus accumbens (NAcc: 8NS, 13S). ANCOVA was used to control for age, gender, pH and RNA degradation, with P≤0.01 and fold change±1.25 as criteria for significance. Pathway analysis revealed serotonergic signaling alterations in the DLPFC and glucocorticoid signaling alterations in the ACC and NAcc. The gene with the lowest p-value in the DLPFC was the 5-HT2A gene, previously associated both with suicide and mood disorders. In the ACC 6 metallothionein genes were down-regulated in suicide (MT1E, MT1F, MT1G, MT1H, MT1X, MT2A) and three were down-regulated in the NAcc (MT1F, MT1G, MT1H). Differential expression of selected genes was confirmed by qPCR, we confirmed the 5-HT2A alterations and the global down-regulation of members of the metallothionein subfamilies MT 1 and 2 in suicide completers. MTs 1 and 2 are neuro-protective following stress and glucocorticoid stimulations, suggesting that in suicide victims neuroprotective response to stress and cortisol may be diminished. Our results thus suggest that suicide-specific expression changes in mood disorders involve both glucocorticoids regulated metallothioneins and serotonergic signaling in different regions of the brain.
Collapse
Affiliation(s)
- Adolfo Sequeira
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California, United States of America.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Freuchen A, Kjelsberg E, Lundervold AJ, Grøholt B. Differences between children and adolescents who commit suicide and their peers: A psychological autopsy of suicide victims compared to accident victims and a community sample. Child Adolesc Psychiatry Ment Health 2012; 6:1. [PMID: 22216948 PMCID: PMC3284874 DOI: 10.1186/1753-2000-6-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 01/04/2012] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to gain knowledge about the circumstances related to suicide among children and adolescents 15 years and younger. METHODS We conducted a psychological autopsy, collecting information from parents, hospital records and police reports on persons below the age of 16 who had committed suicide in Norway during a 12-year period (1993-2004) (n = 41). Those who committed suicide were compared with children and adolescents who were killed in accidents during the same time period (n = 43) and with a community sample. RESULTS Among the suicides 25% met the criteria for a psychiatric diagnosis and 30% had depressive symptoms at the time of death. Furthermore, 60% of the parents of the suicide victims reported the child experienced some kind of stressful conflict prior to death, whereas only 12% of the parents of the accident victims reported such conflicts. CONCLUSION One in four suicide victims fulfilled the criteria for a psychiatric diagnosis. The level of sub-threshold depression and of stressful conflict experienced by youths who committed suicide did not appear to differ substantially from that of their peers, and therefore did not raise sufficient concern for referral to professional help.
Collapse
Affiliation(s)
- Anne Freuchen
- Department of Psychiatry, Faculty of Medicine, University of Oslo, N-0316 Oslo, Norway.
| | - Ellen Kjelsberg
- Centre for Forensic Psychiatry, Oslo University Hospital, N-0407 Oslo, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, Uni Research, K.G.Jebsen Centre for Reasearch on Neuropschyiatric Disorders, University of Bergen, N-5009 Bergen, Norway
| | - Berit Grøholt
- Institute of clinical medicine, Faculty of medicine, University of Oslo, N-0361 Oslo, Norway
| |
Collapse
|
26
|
van Tilburg MAL, Spence NJ, Whitehead WE, Bangdiwala S, Goldston DB. Chronic pain in adolescents is associated with suicidal thoughts and behaviors. THE JOURNAL OF PAIN 2011; 12:1032-9. [PMID: 21684217 PMCID: PMC3178682 DOI: 10.1016/j.jpain.2011.03.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 02/15/2011] [Accepted: 03/14/2011] [Indexed: 01/01/2023]
Abstract
UNLABELLED Adults who suffer from chronic pain are at increased risk for suicide ideation and attempts, but it is not clear whether adolescents with chronic pain are similarly at elevated risk. This study investigates whether chronic pain is associated with an increase in suicidal ideation/attempts independent of depression in a population sample of adolescents. We analyzed data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in the United States (N = 9,970). Most chronic pain was related to suicide ideation/attempt both in the last year (odds ratio [OR] 1.3-2.1) and during the subsequent year (OR 1.2-1.8). After controlling for depressive symptoms, headaches (OR = 1.3 last year, OR = 1.2 subsequent year) and muscle aches (OR = 1.3 last year) remained associated with suicide ideation but not suicide attempt. These findings show that chronic pain in adolescence is a risk factor for suicide ideation; this effect is partly but not fully explained by depression. Youth with comorbid depression and chronic pain are at increased risk of thinking about and attempting suicide. Clinicians should be alert to suicide ideation/attempt and comorbid depression in this at-risk population. PERSPECTIVE Adolescents who suffer from chronic pain are at increased risk for suicide ideation and attempt. Depressive symptoms account for the link between chronic pain and suicide attempt, but do not completely explain why adolescents with chronic pain show suicide ideation.
Collapse
Affiliation(s)
- Miranda A L van Tilburg
- University of North Carolina, Center for Functional GI and Motility Disorders, Chapel Hill, North Carolina 27516, USA.
| | | | | | | | | |
Collapse
|
27
|
Sher L. Brain-derived neurotrophic factor and suicidal behavior in adolescents. World J Pediatr 2011; 7:197-8. [PMID: 21822986 DOI: 10.1007/s12519-011-0316-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 03/31/2011] [Indexed: 01/19/2023]
|
28
|
Greydanus DE, Apple RW. The relationship between deliberate self-harm behavior, body dissatisfaction, and suicide in adolescents: current concepts. J Multidiscip Healthc 2011; 4:183-9. [PMID: 21811385 PMCID: PMC3141836 DOI: 10.2147/jmdh.s11569] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Deliberate self-harm (DSH) is a common though often hidden condition in children and adolescents that may result in suicide. This discussion covers several aspects of DSH including its prevalence, etiology, and management. The relationships of DSH to body dissatisfaction and suicide are specifically considered. Even though most cases of DSH do not end in overt suicide, DSH reflects that potential underlying psychological pathophysiology, and likelihood of eventual death from self-murder, cannot always be predicted or prevented. It is important to take all acts of DSH as serious, and to offer comprehensive management to prevent future acts of DSH and potential suicide.
Collapse
Affiliation(s)
- Donald E Greydanus
- Pediatrics and Human Development; College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | | |
Collapse
|
29
|
Greydanus D, Patel D, Pratt H. Suicide risk in adolescents with chronic illness: implications for primary care and specialty pediatric practice: a review. Dev Med Child Neurol 2010; 52:1083-7. [PMID: 20813018 DOI: 10.1111/j.1469-8749.2010.03771.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Suicide in adolescents is a global tragedy. Research-identified correlates of suicide in youth include depression, academic failure, loss of friends, social isolation, and substance abuse, among others. This review focuses on the potential link between chronic illness in adolescents and increased suicide risk. Research suggests that chronic illness is a risk factor for depression in adolescents that may induce suicide ideation and attempts; however, this risk may be increased even more in young adulthood if the underlying causes of depression are not resolved. This risk needs to be considered against the research data noting an increase in suicide attempts and completions, in each decade of life from adolescence into adulthood. Although more research is clearly needed, it can be concluded that suicide risks are seen in adolescents with chronic illness and all of these young people should be screened for depression and other risk factors for suicide on a regular basis.
Collapse
Affiliation(s)
- Donald Greydanus
- The Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI 49008-1284, USA.
| | | | | |
Collapse
|
30
|
Caycedo A, Arenas ML, Benítez M, Cavanzo P, Leal G, Guzmán YR. Psycho-Social and Family Characteristics Related to Attempted Suicide in an Adolescent Population in Bogotá-2009. PERSONA Y BIOÉTICA 2010. [DOI: 10.5294/pebi.2010.14.2.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Las conductas suicidas se han constituido en una causa importante de morbi-mortalidad mundial. En el 2006, el suicidio pasó al tercer lugar como principal causa de muerte en personas de 15 a 44 años. Se han identificado factores de riesgo para esta conducta y signos de alarma específicos, sin embargo, los adolescentes presentan riesgos adicionales como imitación, identificación social e inestabilidad emocional.
Se realizó un estudio transversal descriptivo en adolescentes entre los 10 y 17 años que consultaron por intento de suicidio al servicio de urgencias de dos hospitales en Bogotá, aplicando un instrumento de recolección de información diligenciado por los padres o acudientes de 14 casos, previa firma de consentimiento informado. El estudió mostró que la edad más prevalente fueron los 16 años, representando el 43%; el género fue el femenino, representando el 71,5%. Ninguno reportó diagnóstico de enfermedad mental previa, y solo en tres casos hubo reporte de consumo de sustancias.
Ninguno de los casos reportó que los pacientes hubieran tenido comportamientos de búsqueda de ayuda previa.
Debido al reducido número de casos sólo se pueden describir hallazgos reportados, en este momento no se pueden hacer afirmaciones con respecto a características familiares, para esto se requeriría aplicar el instrumento en un mayor número de pacientes.
Collapse
|
31
|
Coker TR, Austin SB, Schuster MA. The health and health care of lesbian, gay, and bisexual adolescents. Annu Rev Public Health 2010; 31:457-77. [PMID: 20070195 DOI: 10.1146/annurev.publhealth.012809.103636] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Adolescents face a variety of challenges in their transition to adulthood; lesbian, gay, and bisexual adolescents face these typical challenges as well as additional challenges that are related to the social stigma of their sexual orientation. For some lesbian, gay, and bisexual adolescents, this stigma may induce psychosocial stress, leading to increased health risk behaviors and poorer health outcomes. In this article, we review data on the health and health care of LGB adolescents. We examine health indicators and health risks for LGB youth, including substance use, eating disorders, suicidality, risky sexual behaviors, violence exposure and victimization, and homelessness. We also examine health care provision and utilization for LGB youth. Lastly, we discuss ways in which researchers and clinicians can improve LGB adolescent health and health care.
Collapse
Affiliation(s)
- Tumaini R Coker
- Division of General Pediatrics, Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California 90024, USA.
| | | | | |
Collapse
|
32
|
Abstract
Deliberate self-harm (DSH) is a widespread yet often hidden problem in adolescents and young adults. Though most DSH can be classified as "non-suicidal self-cutting", some do go on to commit suicide. In this paper, deliberate self-harm is examined, including its prevalence, etiology, management, and future research directions using self-cutting and self-burning as examples. This article reviews recent literature to help understand what is known about self-cutting behavior and its potential relationship to suicide as well as provide direction for research. Research shows that different ecological factors at the individual, family, peer, and societal levels are related to deliberate self-harm. Although there is an association between some self-injurers and drug abuse (including alcohol abuse) as well as eating disorders, there are various subgroups of self-cutters and most are not at high risk for suicide. However, all acts of self-injury should be taken seriously by health care professionals and comprehensive therapy offered to any adolescent with a history of DSH. Future research directions on deliberate self-harm are also discussed.
Collapse
|
33
|
Souza LDDM, Silva RAD, Jansen K, Kuhn RP, Horta BL, Pinheiro RT. Suicidal ideation in adolescents aged 11 to 15 years: prevalence and associated factors. ACTA ACUST UNITED AC 2009; 32:37-41. [PMID: 19918674 DOI: 10.1590/s1516-44462009005000011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 08/10/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To verify the prevalence and associated factors of suicidal ideation among adolescents aged 11 to 15 years. METHOD Cross-sectional population-based study. Adolescents completed a self-report that contained the Children's Depression Inventory. Suicidal ideation was measured according to item 9 of the Children's Depression Inventory. Multivariate logistic regression analysis was applied using a hierarchical model. RESULTS 1145 adolescents were invited to participate, and 1039 were interviewed (refusal rate: 9.26%). The prevalence of suicidal ideation was 14.1%. Factors associated to suicidal ideation: female gender, current alcohol consumption, use of illicit drugs, symptoms indicating conduct disorders and high Children's Depression Inventory scores for depressive symptoms. CONCLUSION Prevention strategies should focus on female adolescents, especially those sexually active with probable mental health problems and substance use.
Collapse
|
34
|
Abstract
The tragedy of suicide in adolescents is experienced by all countries of the world with as many as 200,000 youth and young adults ending their life in the prime of their life because of self-murder each year. Such a tragedy should be unacceptable to clinicians of the world and this article examines factors leading to such death in our youth with recommendations on how to prevent such a worldwide carnage. A major issue in suicide prevention is to screen all children and adolescents for depression and other factors that may trigger suicide in adolescence.
Collapse
|
35
|
Värnik A, Kõlves K, Allik J, Arensman E, Aromaa E, van Audenhove C, Bouleau JH, van der Feltz-Cornelis CM, Giupponi G, Gusmão R, Kopp M, Marusic A, Maxwell M, Oskarsson H, Palmer A, Pull C, Realo A, Reisch T, Schmidtke A, Pérez Sola V, Wittenburg L, Hegerl U. Gender issues in suicide rates, trends and methods among youths aged 15-24 in 15 European countries. J Affect Disord 2009; 113:216-26. [PMID: 18625519 DOI: 10.1016/j.jad.2008.06.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2008] [Revised: 06/01/2008] [Accepted: 06/01/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND No recent cross-country examinations for youth suicide trends and methods for Europe were found. AIM The aim of the study is to specify differences in suicide rates, trends and methods used among 15-24 years olds by gender across 15 European countries. METHOD Data for 14,738 suicide cases in the age group 15-24 in 2000-2004/5 were obtained and analysed. RESULTS Suicide rates ranged 5.5-35.1 for males and 1.3-8.5 for females. Statistically significant decline since 2000 was observed in Germany, Scotland, Spain, and England for males and in Ireland for females. Hanging was most frequently used for both genders, followed by jumping and use of a moving object for males and jumping and poisoning by drugs for females. Male suicides had a higher risk than females of using firearms and hanging and lower risk of poisoning by drugs and jumping. There were large differences between single countries. LIMITATIONS The limitations of the study are the small numbers of specific suicide methods in some countries as well as the re-categorisation of ICD-9 codes into ICD-10 in England, Ireland and Portugal. Further, the use of suicides (X60-X84) without events of undetermined deaths (Y10-Y34) continues to be problematic considering the possibility of "hidden suicides". CONCLUSIONS The present study shows that suicide rates among young males are decreasing since 2000 in several European countries. Analysis of suicide methods confirms that there is a very high proportion of hanging in youths, which is extremely difficult to restrict. However, besides hanging there are also high rates of preventable suicide methods and reducing the availability of means should be one of the goals of suicide prevention.
Collapse
Affiliation(s)
- Airi Värnik
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioural and Health Sciences, Tallinn, Estonia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|