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Selak Š, Crnkovič N, Šorgo A, Gabrovec B, Cesar K, Žmavc M. Resilience and social support as protective factors against suicidal ideation among tertiary students during COVID-19: a cross-sectional study. BMC Public Health 2024; 24:1942. [PMID: 39030522 PMCID: PMC11265007 DOI: 10.1186/s12889-024-19470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 07/12/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Suicidal ideation is a depression symptom which represents a key (cognitive) component of suicidality and plays an important role in suicide risk detection, intervention, and prevention. Despite existing research showing the importance of certain factors of depression symptoms and suicidal ideation, less is known about the interaction between the various risk and protective factors. The aim of the study was to examine whether living conditions characteristics and personal circumstances during the COVID-19 pandemic predicted the presence of depression symptoms and suicidal ideation among tertiary students and whether resilience and social support can mitigate the detrimental effects of difficult life circumstances. METHOD A large online cross-sectional study was conducted in March 2021 among 4,645 Slovenian tertiary students. Hierarchical multiple regression and hierarchical logistic regression methods were used to assess and compare the effect of life circumstances variables, as opposed to resilience and social support, on depression symptoms and suicidal ideation. RESULTS Female gender, single relationship status, living alone, a higher degree of household conflict, having a history of mental illness and chronic disease diagnosis were significant predictors of depression scores. All but gender were also predictors of suicidal ideation. Household conflict and a history of mental illness were the factors showing the strongest effect in both cases. On the other hand, social support and, in particular, resilience proved to be strong protective factors against depression symptoms and suicidal ideation. After accounting for one's resilience and social support, the explained variance in depression scores was more than doubled, while the harmful effect of household conflict and history of mental illness significantly decreased. CONCLUSIONS The findings stress the importance of one's resilience and social support and explain why some people manage to maintain mental well-being despite finding themselves in difficult life circumstances, which was the case for many tertiary students during the COVID-19 pandemic. These insights may inform preventive efforts against developing suicidal ideation and may be used as support for the design and implementation of interventions for improving resilience and social support from childhood onward.
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Affiliation(s)
- Špela Selak
- National Institute of Public Health, Ljubljana, Slovenia.
| | - Nuša Crnkovič
- National Institute of Public Health, Ljubljana, Slovenia
| | - Andrej Šorgo
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | | | - Katarina Cesar
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mark Žmavc
- Centre for Digital Wellbeing Logout, Ljubljana, Slovenia
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Liu Q, Teng CC, Sun I, Muñoz RF, Garza M, Liu NH, Barakat S, Leykin Y. Suicide attempts in the absence of depression: Differences between broad cultural groups. J Affect Disord 2024; 356:722-727. [PMID: 38657769 DOI: 10.1016/j.jad.2024.04.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Suicide is one of the leading causes of death worldwide (WHO, 2021). Depression is a common precursor to suicide and suicidality; however, individuals' experience of depression and the meaning of suicide differs depending on one's cultural background (Colucci, 2013; Goodmann et al., 2021; Kleinman, 2004). The current study explores the relationship between suicide and depression among six broad cultural groups in a large sample (N = 17,015) of adults representing six broad cultural groups (Latin America, South Asia, former Soviet Bloc, Western English-speakers, Chinese, and Arab World). Participants were recruited to a multilingual depression and suicide screening study via Google Ads (Leykin et al., 2012; Gross et al., 2014). As expected, the presence of depression was associated with suicide attempts. However, cultural group moderated this association, with Chinese participants being most likely to report suicide attempts while screening negative for depression. Although depression remains an important predictor of suicidality, it appears that certain cultural groups may be at higher risk even when depression is not present. Clinicians should consider using culturally adapted assessments for depression and suicidality.
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Affiliation(s)
| | | | | | - Ricardo F Muñoz
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America
| | - Monica Garza
- Legacy Community Health, United States of America
| | - Nancy H Liu
- University of California, Berkeley, United States of America
| | - Suzanne Barakat
- University of California, San Francisco, United States of America
| | - Yan Leykin
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America.
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Weber DM, Halverson TF, Daruwala SE, Pugh MJ, Calhoun PS, Beckham JC, Kimbrel NA. Love Is Not All You Need: Understanding the Association Between Relationship Status and Relationship Dysfunction With Self-Directed Violence in Veterans. Arch Suicide Res 2024; 28:844-859. [PMID: 37548583 DOI: 10.1080/13811118.2023.2237097] [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] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk. METHOD Veterans (N = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors. RESULTS Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans. CONCLUSION It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.
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Xiao Y, Bi K, Yip PSF, Cerel J, Brown TT, Peng Y, Pathak J, Mann JJ. Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis. JAMA Psychiatry 2024; 81:595-605. [PMID: 38506817 PMCID: PMC10955339 DOI: 10.1001/jamapsychiatry.2024.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/07/2024] [Indexed: 03/21/2024]
Abstract
Importance Suicide rates in the US increased by 35.6% from 2001 to 2021. Given that most individuals die on their first attempt, earlier detection and intervention are crucial. Understanding modifiable risk factors is key to effective prevention strategies. Objective To identify distinct suicide profiles or classes, associated signs of suicidal intent, and patterns of modifiable risks for targeted prevention efforts. Design, Setting, and Participants This cross-sectional study used data from the 2003-2020 National Violent Death Reporting System Restricted Access Database for 306 800 suicide decedents. Statistical analysis was performed from July 2022 to June 2023. Exposures Suicide decedent profiles were determined using latent class analyses of available data on suicide circumstances, toxicology, and methods. Main Outcomes and Measures Disclosure of recent intent, suicide note presence, and known psychotropic usage. Results Among 306 800 suicide decedents (mean [SD] age, 46.3 [18.4] years; 239 627 males [78.1%] and 67 108 females [21.9%]), 5 profiles or classes were identified. The largest class, class 4 (97 175 [31.7%]), predominantly faced physical health challenges, followed by polysubstance problems in class 5 (58 803 [19.2%]), and crisis, alcohol-related, and intimate partner problems in class 3 (55 367 [18.0%]), mental health problems (class 2, 53 928 [17.6%]), and comorbid mental health and substance use disorders (class 1, 41 527 [13.5%]). Class 4 had the lowest rates of disclosing suicidal intent (13 952 [14.4%]) and leaving a suicide note (24 351 [25.1%]). Adjusting for covariates, compared with class 1, class 4 had the highest odds of not disclosing suicide intent (odds ratio [OR], 2.58; 95% CI, 2.51-2.66) and not leaving a suicide note (OR, 1.45; 95% CI, 1.41-1.49). Class 4 also had the lowest rates of all known psychiatric illnesses and psychotropic medications among all suicide profiles. Class 4 had more older adults (23 794 were aged 55-70 years [24.5%]; 20 100 aged ≥71 years [20.7%]), veterans (22 220 [22.9%]), widows (8633 [8.9%]), individuals with less than high school education (15 690 [16.1%]), and rural residents (23 966 [24.7%]). Conclusions and Relevance This study identified 5 distinct suicide profiles, highlighting a need for tailored prevention strategies. Improving the detection and treatment of coexisting mental health conditions, substance and alcohol use disorders, and physical illnesses is paramount. The implementation of means restriction strategies plays a vital role in reducing suicide risks across most of the profiles, reinforcing the need for a multifaceted approach to suicide prevention.
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Affiliation(s)
- Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine/NewYork-Presbyterian, New York
| | - Kaiwen Bi
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Paul Siu-Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington
| | | | - Yifan Peng
- Department of Population Health Sciences, Weill Cornell Medicine/NewYork-Presbyterian, New York
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine/NewYork-Presbyterian, New York
| | - J. John Mann
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, New York
- Department of Radiology, Columbia University Irving Medical Center, Columbia University, New York, New York
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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Edwards AC, Ohlsson H, Salvatore JE, Stephenson ME, Crump C, Sundquist J, Sundquist K, Kendler KS. Divorce and risk of suicide attempt: a Swedish national study. Psychol Med 2024; 54:1620-1628. [PMID: 38084643 DOI: 10.1017/s0033291723003513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
BACKGROUND Prior research has reported an association between divorce and suicide attempt. We aimed to clarify this complex relationship, considering sex differences, temporal factors, and underlying etiologic pathways. METHODS We used Swedish longitudinal national registry data for a cohort born 1960-1990 that was registered as married between 1978 and 2018 (N = 1 601 075). We used Cox proportional hazards models to estimate the association between divorce and suicide attempt. To assess whether observed associations were attributable to familial confounders or potentially causal in nature, we conducted co-relative analyses. RESULTS In the overall sample and in sex-stratified analyses, divorce was associated with increased risk of suicide attempt (adjusted hazard ratios [HRs] 1.66-1.77). Risk was highest in the year immediately following divorce (HRs 2.20-2.91) and declined thereafter, but remained elevated 5 or more years later (HRs 1.41-1.51). Divorcees from shorter marriages were at higher risk for suicide attempt than those from longer marriages (HRs 3.33-3.40 and 1.20-1.36, respectively). In general, HRs were higher for divorced females than for divorced males. Co-relative analyses suggested that familial confounders and a causal pathway contribute to the observed associations. CONCLUSIONS The association between divorce and risk of suicide attempt is complex, varying as a function of sex and time-related variables. Given evidence that the observed association is due in part to a causal pathway from divorce to suicide attempt, intervention or prevention efforts, such as behavioral therapy, could be most effective early in the divorce process, and in particular among females and those whose marriages were of short duration.
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Affiliation(s)
- Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jessica E Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Mallory E Stephenson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Casey Crump
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Yin Y, Workman TE, Blosnich JR, Brandt CA, Skanderson M, Shao Y, Goulet JL, Zeng-Treitler Q. Sexual and Gender Minority Status and Suicide Mortality: An Explainable Artificial Intelligence Analysis. Int J Public Health 2024; 69:1606855. [PMID: 38770181 PMCID: PMC11103011 DOI: 10.3389/ijph.2024.1606855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Objectives: Suicide risk is elevated in lesbian, gay, bisexual, and transgender (LGBT) individuals. Limited data on LGBT status in healthcare systems hinder our understanding of this risk. This study used natural language processing to extract LGBT status and a deep neural network (DNN) to examine suicidal death risk factors among US Veterans. Methods: Data on 8.8 million veterans with visits between 2010 and 2017 was used. A case-control study was performed, and suicide death risk was analyzed by a DNN. Feature impacts and interactions on the outcome were evaluated. Results: The crude suicide mortality rate was higher in LGBT patients. However, after adjusting for over 200 risk and protective factors, known LGBT status was associated with reduced risk compared to LGBT-Unknown status. Among LGBT patients, black, female, married, and older Veterans have a higher risk, while Veterans of various religions have a lower risk. Conclusion: Our results suggest that disclosed LGBT status is not directly associated with an increase suicide death risk, however, other factors (e.g., depression and anxiety caused by stigma) are associated with suicide death risks.
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Affiliation(s)
- Ying Yin
- Washington DC VA Medical Center, United States Department of Veterans Affairs, Washington, DC, United States
- Biomedical Informatics Center, The George Washington University, Washington, DC, United States
| | - T. Elizabeth Workman
- Washington DC VA Medical Center, United States Department of Veterans Affairs, Washington, DC, United States
- Biomedical Informatics Center, The George Washington University, Washington, DC, United States
| | - John R. Blosnich
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, Pittsburgh, PA, United States
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Cynthia A. Brandt
- VA Connecticut Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, West Haven, CT, United States
| | - Melissa Skanderson
- VA Connecticut Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, West Haven, CT, United States
| | - Yijun Shao
- Washington DC VA Medical Center, United States Department of Veterans Affairs, Washington, DC, United States
- Biomedical Informatics Center, The George Washington University, Washington, DC, United States
| | - Joseph L. Goulet
- Pain, Research, Informatics, Multi-Morbidities, and Education Center, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Qing Zeng-Treitler
- Washington DC VA Medical Center, United States Department of Veterans Affairs, Washington, DC, United States
- Biomedical Informatics Center, The George Washington University, Washington, DC, United States
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Strømme MF, Bartz-Johannessen C, Kjelby E, Mehlum L, Mykletun A, Kroken RA, Johnsen E, Gjestad R. Risk factors for mortality in patients admitted to a psychiatric acute ward: A prospective cohort study. Acta Psychiatr Scand 2024; 149:244-255. [PMID: 38225748 DOI: 10.1111/acps.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024]
Abstract
INTRODUCTION Associations between psychiatric disorders and mortality have been extensively studied, but limited evidence exists regarding influence of clinical characteristics on mortality risk, at the time of acute psychiatric hospitalization. METHODS A prospective total-cohort study included all patients consecutively admitted to Haukeland University Hospital's psychiatric acute ward in Bergen, Norway between 2005 and 2014 (n = 6125). Clinical interviews were conducted at the first admission within the study period, and patients were subsequently followed for up to 15 years in the Norwegian Cause of Death Registry. Competing risks regression models were used to investigate associations between clinical characteristics at first admission and the risk of natural and unnatural death during follow-up. RESULTS The mean age at first admission and at time of death was 42.5 and 62.8 years, respectively, and the proportion of women in the sample was 47.2%. A total of 1381 deaths were registered during follow-up, of which 65.5% had natural, 30.4% unnatural, and 4.1% unknown causes. Higher age, male sex, unemployment, cognitive deficits, and physical illness were associated with increased risk of natural death. Male sex, having no partner, physical illness, suicide attempts, and excessive use of alcohol and illicit substances were associated with increased risk of unnatural death. CONCLUSION Psychiatric symptoms, except suicide attempts, were unrelated to increased mortality risk. In the endeavor to reduce the increased mortality risk in people with mental disorders, focus should be on addressing modifiable risk factors linked to physical health and excessive use of alcohol and illicit substances.
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Affiliation(s)
- Maria Fagerbakke Strømme
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- NORMENT, Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Christoffer Bartz-Johannessen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- NORMENT, Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Eirik Kjelby
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- NORMENT, Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Arnstein Mykletun
- Division of Psychiatry, Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
- Department for Community Medicine, University of Tromsø, Tromsø, Norway
| | - Rune Andreas Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- NORMENT, Centre of Excellence, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- NORMENT, Centre of Excellence, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division of Psychiatry, Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
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Chen J, Lui ID, Hsu YC, Yip PSF. Patterns in suicide by marital status in Hong Kong, 2002-2020: Is marriage still a protective factor against suicide? J Affect Disord 2024; 346:31-39. [PMID: 37866734 DOI: 10.1016/j.jad.2023.10.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/25/2023] [Accepted: 10/15/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Marriage has long been considered protective against suicide, but shifting social norms since 2000 in Hong Kong raise doubts regarding whether this is still the case. The aim of the study was to investigate the changing association between suicide and marital status. METHODS Official suicide data for 2002-2020 in Hong Kong were obtained. Suicide rates and suicide risk ratios were calculated by gender, age group, and marital status (married, never-married, widowed, divorced/separated). RESULTS Suicide risk decreased significantly over time for men and women of all ages. People who were never-married, divorced/separated, had significantly higher suicide risks than their married counterparts. Increasing suicide risks over time were observed for never-married men aged 20-49 years, never-married women aged 35-49 years, and divorced/separated men aged 20-34 years. Widowed men and women of any age had higher suicide risks compared with previous studies in Hong Kong. LIMITATIONS Marital status is a time-varying covariate, and the time spent in a given marital status could affect suicide risk. Some age and gender subgroups had much smaller sample sizes than others, thus it is possible that our suicide risk estimates were overestimated. CONCLUSIONS Despite rapidly social changing in Hong Kong during the study period, marriage remains a strong protective factor against suicide for men and women. The protective effect is particularly evident for younger people. Increasing suicide rates for divorced/separated, never-married, or widowed people suggest that they require more psychosocial support.
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Affiliation(s)
- Junyou Chen
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Ingrid D Lui
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Yu Cheng Hsu
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Paul S F Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong.
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Stephenson M, Prom-Wormley E, Lannoy S, Edwards AC. The temporal relationship between marriage and risk for suicidal ideation. J Affect Disord 2023; 343:129-135. [PMID: 37802325 PMCID: PMC10594900 DOI: 10.1016/j.jad.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Marriage is consistently identified as a protective factor for suicidality, but it remains unclear whether this relationship varies by time elapsed since the transition to marriage. METHODS Participants were 15,870 individuals (52 % female, mean age = 44.63 years, age range = 18-99 years) from the Collaborative Psychiatric Epidemiology Surveys. Cox proportional hazards models were used to test the relationship between marriage, as well as time elapsed since the transition to marriage (0-5 years, 6-10 years, or 11+ years), and suicidal ideation. Years of education and race and ethnicity were included as covariates, and analyses were stratified by sex. Separate hazard ratios were estimated for individuals aged <30 years and 30+ years to address violations of the proportionality assumption. RESULTS Being married was associated with lower risk for suicidal ideation across age and sex. Among individuals aged <30 years, marriage was reliably associated with lower risk for suicidal ideation, regardless of the time elapsed since marriage. For individuals aged 30+ years, being married for 0-5 years or 6-10 years was associated with increased risk for suicidal ideation, particularly in females. Being married for 11+ years was associated with decreased risk across sex. LIMITATIONS Analyses focused on participants' first marriage and did not examine mediators of the association between marriage and suicidal ideation. CONCLUSIONS Overall, being married protects against suicidal ideation. However, among individuals aged 30 years or older, the first 10 years of marriage are associated with elevated risk for suicidal thoughts, and clinical outreach may be warranted.
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Affiliation(s)
- Mallory Stephenson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, United States of America.
| | | | - Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, United States of America
| | - Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, United States of America
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Arafat SMY, Menon V, Khan MAS, Htay MNN, Singh R, Biyyala D, Krishnamoorthy Y, Mynampally K. Marital status and suicidal behavior in South Asia: A systematic review and meta-analysis. Health Sci Rep 2023; 6:e1781. [PMID: 38130329 PMCID: PMC10733573 DOI: 10.1002/hsr2.1781] [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: 08/22/2023] [Revised: 10/18/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims The connection between marital status and suicidal behavior has been poorly assessed in South Asia. We aimed to see the proportion of marital status in individuals with suicidal behavior in South Asian countries. Methods We followed PRISMA guidelines and registered the protocol in advance (PROSPERO 2023 CRD42023399906). A systematic search was conducted in Medline, Embase, and PsycINFO. Meta-analyses were performed to pool the proportion of married individuals with suicidal behavior (total [suicide + suicide attempts], suicide, and suicide attempt) in South Asian countries. We considered suicidal behavior consist of suicide and suicide attempts (nonfatal). Results Our search identified 47 studies for this review from 6 countries published from 1999 to 2022 with a sample size ranging from 27 to 89,178. The proportion of married individuals was 55.4% (95% CI: 50.1-60.5) for suicidal behavior, 52.7% (95% CI: 44.5-60.7) for suicides, and 43.1 (95% CI: 32.9-53.9) for suicide attempts. The proportion of married persons among suicide attempts varied significantly across countries (p = 0.016) which was highest (61.8%; 95% CI: 57.2-66.2) in India, followed by Bangladesh (52.5%; 95% CI: 41.8%-62.9%) and Pakistan (45.1%; 95% CI: 30.9-59.9). The pooled proportions did not differ significantly in relation to the quality of the studies (p = 0.633). Conclusion This review identified married persons died more than others by suicide in South Asian countries while single persons attempted suicide than married. As the current study did not assess any cause-and-effect association, a cautious interpretation is warranted while considering married marital status as a risk factor.
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Affiliation(s)
- S. M. Yasir Arafat
- Department of PsychiatryEnam Medical College and HospitalDhakaBangladesh
| | - Vikas Menon
- Department of PsychiatryJawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryIndia
| | - Md Abdullah Saeed Khan
- Department of Community MedicineNational Institute of Preventive and Social Medicine (NIPSOM)DhakaBangladesh
| | - Mila Nu Nu Htay
- Department of Community MedicineManipal University College Malaysia, Faculty of MedicineMelakaMalaysia
| | - Rakesh Singh
- Department of Research – Transcultural Psychosocial Organization NepalKathmanduNepal
| | | | | | - Keerthana Mynampally
- Department of PsychiatryJawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryIndia
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Favril L, Yu R, Geddes JR, Fazel S. Individual-level risk factors for suicide mortality in the general population: an umbrella review. Lancet Public Health 2023; 8:e868-e877. [PMID: 37898519 PMCID: PMC10932753 DOI: 10.1016/s2468-2667(23)00207-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Deaths by suicide remain a major public health challenge worldwide. Identifying and targeting risk factors for suicide mortality is a potential approach to prevention. We aimed to summarise current knowledge on the range and magnitude of individual-level risk factors for suicide mortality in the general population and evaluate the quality of the evidence. METHODS In this umbrella review, five bibliographic databases were systematically searched for articles published from database inception to Aug 31, 2022. We included meta-analyses of observational studies on individual-level risk factors for suicide mortality in the general population. Biological, genetic, perinatal, and ecological risk factors were beyond the scope of this study. Effect sizes were synthesised and compared across domains. To test robustness and consistency of the findings, evidence for small-study effects and excess significance bias (ie, the ratio between the overall meta-analysis effect size and that of its largest included study) was examined, and prediction intervals were calculated. Risk of bias was assessed by the Risk of Bias in Systematic Reviews instrument. The protocol was pre-registered with PROSPERO (CRD42021230119). FINDINGS We identified 33 meta-analyses on 38 risk factors for suicide mortality in the general population. 422 (93%) of the 454 primary studies included in the meta-analyses were from high-income countries. A previous suicide attempt and suicidal ideation emerged as strong risk factors (with effect sizes ranging from 6 to 16). Psychiatric disorders were associated with a greatly elevated risk of suicide mortality, with risk ratios in the range of 4-13. Suicide risk for physical illnesses (such as cancer and epilepsy) and sociodemographic factors (including unemployment and low education) were typically increased two-fold. Contact with the criminal justice system, state care in childhood, access to firearms, and parental death by suicide also increased the risk of suicide mortality. Among risk factors for which sex-stratified analyses were available, associations were generally similar for males and females. However, the quality of the evidence was limited by excess significance and high heterogeneity, and prediction intervals suggested poor replicability for almost two-thirds of identified risk factors. INTERPRETATION A wide range of risk factors were identified across various domains, which underscores suicide mortality as a multifactorial phenomenon. Prevention strategies that span individual and population approaches should account for the identified factors and their relative strengths. Despite the large number of risk factors investigated, few associations were supported by robust evidence. Evidence of causal inference will need to be tested in high-quality study designs. FUNDING Wellcome Trust.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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12
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Yang X, Liu L, Li R. How marital events explain the suicide rate among Chinese. PLoS One 2023; 18:e0286961. [PMID: 37871007 PMCID: PMC10593240 DOI: 10.1371/journal.pone.0286961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/22/2023] [Indexed: 10/25/2023] Open
Abstract
AIMS The aims for this study was to prove the impacts of marital events (marriage rate, divorce rate and marriage squeeze), economic development, and social development on the suicide rate among urban and rural Chinese and reveal the differences in these impacts between urban and rural areas and between genders. METHODS An explanatory time-series analysis methodology was adopted to analyze the nation-wide data ranging from 1987-2017. RESULTS Marriage rate was a protective factor against the suicide rate among urban and rural men, and rural women; however, divorce rate was a protective factor against the suicide rate only among rural women. For the four groups, the economic development level measured by per capita GDP is a protective factor, while social development measured by urbanization and rural-urban labor migration rates in rural areas plays different roles. CONCLUSIONS Marriage and divorce rates were found to have different meanings for the four groups. This study offers a reference for designing relevant policies and projects to intervene in suicidal behaviors among different groups.
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Affiliation(s)
- Xueyan Yang
- Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Liping Liu
- Population and Development Studies, School of Public Policy and Administration, associate Professor at Sports Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Rui Li
- Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
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13
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Schafer KM, Wilson E, Joiner T. Traumatic brain injury and suicidality among military veterans: The mediating role of social integration. J Affect Disord 2023; 338:414-421. [PMID: 37364657 DOI: 10.1016/j.jad.2023.06.047] [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: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Suicide is a widespread public health concern, including among military Veterans. Traumatic brain injuries (TBIs) and lack of social integration have both been shown to increase risk for suicidality, an outcome that includes, among other suicide-related variables, suicidal ideation, suicide attempts, and suicide death. Interestingly, TBIs have also been identified as a risk factor for social integration problems. In this cross-sectional study we investigated associations between TBI, social integration, and suicidality. Additionally, mediation analysis was used to test whether social integration mediated the association between TBI and suicidality. A sample of 1469 military Veterans (male, n = 1004, 67.2 %; female, n = 457, 32.3 %; transgender/non-binary/prefer not to say, n = 8, 0.5 %) completed an online survey as part of the Military Health and Well-Being Project. TBI was negatively associated with social integration (r = -0.084, p < .001) and positively with suicidality (r = 0.205, p < .001). Social integration was negatively associated with suicidality (r = -0.161, p < .001). Finally, social integration partially mediated the relationship between TBI and social integration (B = 0.121, 95 % CI [0.031-0.23]). This work shows that in the context of TBI, lack of social integration may promote suicidality. It provides support for many theories of suicide which propose social problems as a risk factor of suicide-related outcomes. It further highlights social integration as potential fodder for novel interventions for suicidality, an approach that would have transtheoretical support.
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Affiliation(s)
| | - Emma Wilson
- Kings College London, United States; Florida State University, United States
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14
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Vorstenbosch E, Rodríguez-Liron A, Vicens-Pons E, Félez-Nóbrega M, Escuder-Romeva G. Suicide risk in male incarcerated individuals in Spain: clinical, criminological and prison-related correlates. BMC Psychol 2023; 11:282. [PMID: 37735464 PMCID: PMC10514969 DOI: 10.1186/s40359-023-01315-y] [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: 10/04/2022] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Prison suicide is a complex phenomenon that may be influenced by individual, clinical, social and environmental factors. In Spain, few studies have explored the relationship with institutional, prison-related variables. The aim of this study is to examine correlates of suicide in a sample of male incarcerated individuals from 5 Spanish penitentiary centers. METHODS This present study entails a secondary data analysis, using data from the Prevalence of mental disorders in prisons study. This is a cross-sectional multicenter study conducted in 2007-2008 across 5 penitentiary centers in Spain. The Spanish version of the Plutchik suicide risk scale was used to assess the risk of suicide (those scoring ≥ 6 were considered to be at risk of suicide). Sociodemographic, clinical, criminological and prison-related data were collected via face-to face interviews and criminological data were confirmed using penitentiary records. RESULTS The final sample included 707 male incarcerated individuals (mean age 36.79 years ± 9.90 years). Several significant correlates associated with higher risk of suicide were identified including criminological factors (having committed a violent offense, being a recidivist), clinical factors (family history of mental disorders, the presence of mental disorders, having physical conditions, contact with a mental health specialist, medication treatment in the last 12 months), and prison-related determinants (workshop/training course participation) was significantly associated with lower suicide risk. CONCLUSIONS Several correlates within a comprehensive range of sociodemographic, criminological, clinical and prison-related variables were identified. This information is primordial for preventing suicide and reducing the existing risk. The findings may contribute to developing effective suicide prevention programs within Spanish prison services. Importantly, future research must continue to investigate the nature of suicidal outcomes among incarcerated individuals.
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Affiliation(s)
- Ellen Vorstenbosch
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain.
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Ariadna Rodríguez-Liron
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Enric Vicens-Pons
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Mireia Félez-Nóbrega
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centre for Biomedical Research On Mental Health (CIBERSAM), C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Gemma Escuder-Romeva
- Parc Sanitari Sant Joan de Déu, Research, Teaching and Innovation Unit, C/ Dr. Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Penitentiary Psychiatric Hospitalization Unit of Catalonia, Carretera de Martorell a Capellades, Km 23, 08635, Sant Esteve Sesrovires, Spain
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15
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Pavicic M, Walker AM, Sullivan KA, Lagergren J, Cliff A, Romero J, Streich J, Garvin MR, Pestian J, McMahon B, Oslin DW, Beckham JC, Kimbrel NA, Jacobson DA. Using iterative random forest to find geospatial environmental and Sociodemographic predictors of suicide attempts. Front Psychiatry 2023; 14:1178633. [PMID: 37599888 PMCID: PMC10433206 DOI: 10.3389/fpsyt.2023.1178633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/21/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Despite a recent global decrease in suicide rates, death by suicide has increased in the United States. It is therefore imperative to identify the risk factors associated with suicide attempts to combat this growing epidemic. In this study, we aim to identify potential risk factors of suicide attempt using geospatial features in an Artificial intelligence framework. Methods We use iterative Random Forest, an explainable artificial intelligence method, to predict suicide attempts using data from the Million Veteran Program. This cohort incorporated 405,540 patients with 391,409 controls and 14,131 attempts. Our predictive model incorporates multiple climatic features at ZIP-code-level geospatial resolution. We additionally consider demographic features from the American Community Survey as well as the number of firearms and alcohol vendors per 10,000 people to assess the contributions of proximal environment, access to means, and restraint decrease to suicide attempts. In total 1,784 features were included in the predictive model. Results Our results show that geographic areas with higher concentrations of married males living with spouses are predictive of lower rates of suicide attempts, whereas geographic areas where males are more likely to live alone and to rent housing are predictive of higher rates of suicide attempts. We also identified climatic features that were associated with suicide attempt risk by age group. Additionally, we observed that firearms and alcohol vendors were associated with increased risk for suicide attempts irrespective of the age group examined, but that their effects were small in comparison to the top features. Discussion Taken together, our findings highlight the importance of social determinants and environmental factors in understanding suicide risk among veterans.
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Affiliation(s)
- Mirko Pavicic
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
| | - Angelica M. Walker
- The Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee Knoxville, Knoxville, TN, United States
| | - Kyle A. Sullivan
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
| | - John Lagergren
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
| | - Ashley Cliff
- The Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee Knoxville, Knoxville, TN, United States
| | - Jonathon Romero
- The Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee Knoxville, Knoxville, TN, United States
| | - Jared Streich
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
| | - Michael R. Garvin
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
| | - John Pestian
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, United States
| | - Benjamin McMahon
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - David W. Oslin
- VISN 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jean C. Beckham
- Durham Veterans Affairs Health Care System, Durham, NC, United States
- VA Mid-Atlantic Mental Illness, Research, Education, and Clinical Center, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Health Care System, Durham, NC, United States
- VA Mid-Atlantic Mental Illness, Research, Education, and Clinical Center, Seattle, WA, United States
- Duke University School of Medicine, Duke University, Durham, NC, United States
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, United States
| | - Daniel A. Jacobson
- Oak Ridge National Laboratory, Computational and Predictive Biology, Oak Ridge, TN, United States
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16
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Okamoto N, Ikenouchi A, Chibaatar E, Watanabe K, Igata R, Seki I, Yoshimura R. Risk Factors in Japanese Drug Overdose Patients: Identifying Their Associations With Suicide Risk. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231166970. [PMID: 36972707 DOI: 10.1177/00302228231166970] [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: 03/29/2023]
Abstract
Several suicide attempts presented at the emergency department are due to drug overdose associated with psychiatric disorders. We examined and identified the major risk factors among Japanese drug overdose patients and several close associations of suicide risk. We enrolled 101 patients who attempted suicide by drug overdose between January 2015 and April 2018, assessed their background using the SAD PERSONS scale, and performed association rule analysis to characterize the major risk factors and their associations. We identified three main nodes-depressive state, social support lacking, and no spouse-as considerable risk factors. Furthermore, we identified several close associations of suicide risk and their intensity; in cases with previous suicide attempts and ethanol abuse or substance use, a simultaneous social support lacking is likely. These findings align with previous studies that used conventional statistical analysis on suicide and suicide attempt risk and highlight its importance.
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Affiliation(s)
- Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
- Medical Center for Dementia, University Hospital, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Enkhmurun Chibaatar
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Keita Watanabe
- Open Innovation Institute, Kyoto University, Kyoto, Japan
| | - Ryohei Igata
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Issei Seki
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
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17
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Graham C, Fenelon A. Health, Suicidal Thoughts, and the Life Course: How Worsening Health Emerges as a Determinant of Suicide Ideation in Early Adulthood. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:62-78. [PMID: 36632713 PMCID: PMC10009325 DOI: 10.1177/00221465221143768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Poor physical health places adults at greater risk for suicide ideation. However, the linkage between health and suicidal thoughts may emerge and become established during early adulthood, concomitant with other social processes underlying suicidality. Using nationally representative survey data from Waves III through V of the National Longitudinal Study of Adolescent to Adult Health (n = 8,331), we examine the emergence of health as a predictor of suicide ideation across the early adult life course (ages 18-43). We find that worsening health does not significantly predict suicide ideation until young adults approach the transition into midlife. Our findings suggest this may be due to the increasing severity of health problems, reduced social network engagement, and disruption of social responsibilities later in early adulthood. Our findings underscore the need for social science research to examine the relationship between mental and physical health from a life course perspective.
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Affiliation(s)
- Carlyn Graham
- The Pennsylvania State University -
University Park Campus, University Park, PA, USA
| | - Andrew Fenelon
- The Pennsylvania State University -
University Park Campus, University Park, PA, USA
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18
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Johns L, Zhong C, Mezuk B. Understanding Suicide over the Life Course Using Data Science Tools within a Triangulation Framework. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230003. [PMID: 37168035 PMCID: PMC10168676 DOI: 10.20900/jpbs.20230003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Suicide and suicidal behaviors are important global health concerns. Preventing suicide requires a nuanced understanding of the nature of suicide risk, both acutely during periods of crisis and broader variation over the lifespan. However, current knowledge of the sources of variation in suicide risk is limited due to methodological and conceptual challenges. New methodological approaches are needed to close the gap between research and clinical practice. This review describes the life course framework as a conceptual model for organizing the scientific study of suicide risk across in four major domains: social relationships, health, housing, and employment. In addition, this review discusses the utility of data science tools as a means of identifying novel, modifiable risk factors for suicide, and triangulation as an overarching approach to ensuring rigor in suicide research as means of addressing existing knowledge gaps and strengthening future research.
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19
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Liang S, Li D, Liu X, Jiang I, Zhang J, Liu J, Sha S. Development and validation of a prediction nomogram for non-suicidal self-injury in female patients with mood disorder. Front Psychiatry 2023; 14:1130335. [PMID: 37139312 PMCID: PMC10149817 DOI: 10.3389/fpsyt.2023.1130335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/21/2023] [Indexed: 05/05/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a highly prevalent behavioral problem among people with mental disorders that can result in numerous adverse outcomes. The present study aimed to systematically analyze the risk factors associated with NSSI to investigate a predictive model for female patients with mood disorders. Methods A cross-sectional survey among 396 female patients was analyzed. All participants met the mood disorder diagnostic groups (F30-F39) based on the Diseases and Related Health Problems 10th Revision (ICD-10). The Chi-Squared Test, t-test, and the Wilcoxon Rank-Sum Test were used to assess the differences of demographic information and clinical characteristics between the two groups. Logistic LASSO Regression Analyses was then used to identify the risk factors of NSSI. A nomogram was further used to construct a prediction model. Results After LASSO regression selection, 6 variables remained significant predictors of NSSI. Psychotic symptom at first-episode (β = 0.59) and social dysfunction (β = 1.06) increased the risk of NSSI. Meanwhile, stable marital status (β = -0.48), later age of onset (β = -0.01), no depression at onset (β = -1.13), and timely hospitalizations (β = -0.10) can decrease the risk of NSSI. The C-index of the nomogram was 0.73 in the internal bootstrap validation sets, indicated that the nomogram had a good consistency. Conclusion Our findings suggest that the demographic information and clinical characteristics of NSSI can be used in a nomogram to predict the risk of NSSI in Chinese female patients with mood disorders.
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20
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Elliott MK, Jason LA. Risk factors for suicidal ideation in a chronic illness. DEATH STUDIES 2023; 47:827-835. [PMID: 36240287 DOI: 10.1080/07481187.2022.2132551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Suicide is an urgent concern for people with chronic illnesses, particularly for those with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Prior work has examined suicide risk in this illness, but few studies have examined specific risk factors. This study uses binary logistic regression to identify physical, social, and demographic risk and protective factors for suicidal ideation in ME/CFS (N = 559). The results indicate sleep-related symptoms, stigma, disability status, physical functioning, and marital status as risk factors for suicidal ideation in this group. These findings highlight the importance of education, de-stigmatization, and the search for effective disease-modifying treatments for ME/CFS.
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Affiliation(s)
- Meghan K Elliott
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
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21
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Alexithymia and depressive symptoms mediated the relationship between childhood trauma and suicidal risk in Chinese male prisoners. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Nicholas A, Krysinska K, King KE. A rapid review to determine the suicide risk and risk factors of men who are survivors of sexual assault. Psychiatry Res 2022; 317:114847. [PMID: 36126347 DOI: 10.1016/j.psychres.2022.114847] [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] [Received: 04/04/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 01/04/2023]
Abstract
This rapid review assessed the suicide risk and risk factors of men who are survivors of sexual assault. We searched three academic databases (Cochrane, Medline and PsycINFO) for peer-reviewed articles in English published between 2010 and 2022. We rated the quality of the evidence based on the National Health and Medical Research Council Levels of Evidence. One systematic review and 16 papers featuring primary studies were included relating to suicide rates and risk. Findings suggest men who have been sexually assaulted (as a child or adult) are at increased risk of suicidal thoughts, attempts and behaviours compared with men who have not been sexually assaulted. Factors such as frequency of abuse and other concurrent forms of childhood abuse may further increase the risk of suicidal thoughts and behaviours. This evidence base was rated as good. The strength of this evidence supports a need for targeted suicide prevention in this high risk group.
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Affiliation(s)
- Angela Nicholas
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Kylie E King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
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23
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Single and combined effects of marital status, education attainment, and employment status on suicide among working-age population: A case-control study in South Korea. SSM Popul Health 2022; 19:101246. [PMID: 36238816 PMCID: PMC9550645 DOI: 10.1016/j.ssmph.2022.101246] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/29/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background Suicide in the working-age population is an important public health issue. This group is heterogeneous regarding marital status, education level, and employment status, which are generally important socioeconomic factors for suicide, and has a wide age range. This study aims to explore the individual and combined effect of these socioeconomic factors on suicide in different age groups among the working-age population. Methods This study utilized a population-based case-control design for the working-age population in South Korea. Suicide cases were identified in Korean Governmental Death Registry from 2008 to 2017, and eight controls from Korea Community Health Survey were matched to each case by gender, age group, and year of suicide. Conditional logistic regression models estimated the relationship between marital status and socioeconomic status (SES) including educational attainment and employment status and suicide and examined the combined effect of the SES indicators and marital status on suicide. Results Low education, single status, and unemployment or economically inactive status were associated with suicide, but their magnitude varied across SES indicators. The association between SES and suicide was more pronounced in younger adults. The suicide risk was highest among divorced women aged 25–34 years (OR = 7.93; 95% CI: 7.21–8.72). Individuals experiencing two social adversities among SES or marital status had a significantly increased suicide risk. Those who are divorced and unemployed or economically inactive have the highest suicide risk, specifically among men aged 24–35 years (OR = 17.53; 95% CI: 14.96–20.55). Conclusions Marital status, education attainment, and employment status have a separate and combined impact on suicide among the working-age population. Specifically, the divorced and unemployed or economically inactive status amplified suicide risk, predominantly among young adults. Monitoring and intervention for those young adults should be considered for suicide prevention. Using a case-control design, we were able to demonstrate single as well as the combined impact of socioeconomic status on suicide. Poor SES was associated with suicide, but its magnitude varied across SES indicators. The suicide risk was highest among divorced adults. Individuals with two different types of poor SES and single status had an increased suicide risk. Specifically, those who are divorced and unemployed or economically inactive have the highest suicide risk. The pattern of the association between socioeconomic status and suicide was dependent on age. The association between SES and marital status and suicide was more pronounced in younger adults.
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Parkhurst KA, Daks JS, Conwell Y, Podgorski CA, Van Orden KA. Social network subtypes among socially disconnected older adults at risk for suicide: A latent class analysis. Suicide Life Threat Behav 2022; 52:963-974. [PMID: 35735167 DOI: 10.1111/sltb.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 05/15/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We sought to characterize the social networks of older adults who report feeling lonely or like a burden on others, psychological states that are associated with risk for suicide according to the Interpersonal Theory of Suicide. METHODS We used a latent class analysis to identify distinct groups of older adults based on social network characteristics and perceptions of their networks within a sample of older adults endorsing loneliness and/or feeling like a burden. We examined associations between class membership and mental health outcomes. RESULTS Four network types were identified: small, cohabitating networks with daily contact; moderate-sized family-oriented networks with multiple contacts weekly; moderate-sized friend-oriented networks with weekly contact; and average-sized mixed networks with weekly contact. The friend-oriented class reported the greatest loneliness, perceived burden, and lifetime prevalence of suicidal ideation and attempts. CONCLUSIONS Social network composition may be more explanatory of loneliness and perceived burden than number of members alone. Profile differences in outcomes suggest utilizing tailored social connectedness interventions. Individuals with small-to-moderate networks may benefit most from interventions designed to build friendships. Individuals with many close confidants may benefit most from psychotherapy. Individuals reporting moderately frequent contact with moderately-sized networks may benefit from both intervention types.
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Affiliation(s)
| | - Jennifer S Daks
- Department of Psychology, University of Rochester, Rochester, New York, USA
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Carol A Podgorski
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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Bierman A, Lee Y, Penning MJ. Mental Health Benefits and Detriments of Caregiving Demands: A Nonlinear Association in the Canadian Longitudinal Study on Aging. J Aging Health 2022; 35:392-404. [PMID: 36112750 PMCID: PMC10150259 DOI: 10.1177/08982643221125258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives This study examines whether the association between caregiving demands and mental health is non-linear and also, whether this non-linear association is contingent on the marital status of the caregiver. Methods We analyze the data from the Canadian Longitudinal Study on Aging, applying OLS regression and quadratic interaction terms. Results A lower level of demands is salubriously associated with symptoms of depression and life satisfaction, but this association becomes deleterious at higher levels of demands. Moreover, a connection to a marital partner extends the benefits of caregiving demands and stems the adverse consequences. Discussion This research shows that acts of caregiving may not themselves be detrimental. Instead, the degree and way in which caregiving relates to mental health may vary by both the extent of the demands of the caregiving role and familial relationships in which caregivers are embedded.
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Affiliation(s)
| | - Yeonjung Lee
- University of Calgary, Calgary, AB, Canada
- Chung-Ang University, Seoul, Korea
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Cortero H, McCullom W, Kochuba M. Increased Suicide Risk Among Older White Males. CURRENT TRAUMA REPORTS 2022. [DOI: 10.1007/s40719-022-00233-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shen S, Cheng J, Li J, Xie Y, Wang L, Zhou X, Zhou W, Zhu L, Wang T, Tu J, Bao H, Cheng X. Association of marital status with cognitive function in Chinese hypertensive patients: a cross-sectional study. BMC Psychiatry 2022; 22:504. [PMID: 35897015 PMCID: PMC9327272 DOI: 10.1186/s12888-022-04159-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the association of marital status with cognitive function and to examine the potential effect modifiers in Chinese hypertensive populations. METHODS A total of 9,525 adult Chinese hypertensive patients were enrolled in this cross-sectional study. Cognitive function, as the dependent variable in our study, was assessed by the Chinese version of the Mini-Mental State Examination (MMSE). We adjusted for potential confounding factors in multiple linear regression models to examine the relationship of marital status with cognitive function. In addition, we divided the population according to sex to explore whether there were sex-specific differences. RESULTS Among the 9,525 study participants, the mean (SD) age for men was 63.5 (10.3) years, and the mean MMSE score was 24.9 ± 5.0, whereas for women, the mean (SD) age was 63.8 (9.3) years, and the mean MMSE score was 19.4 ± 6.4. Unmarried persons had lower scores on the MMSE and lower subscores in each of the cognitive domains. A stronger correlation between marital status and a lower MMSE score was statistically significant in men (unmarried men: β = -1.55; 95% CI: -1.89, -1.21) but not women (unmarried women: β = -0.22; 95% CI: -0.56, 0.12; p interaction = 0.006). Compared to men who were widowed or divorced, never married men were more likely to have lower MMSE scores (β = -2.30, 95% CI -3.10,-1.50; p < 0.001). CONCLUSIONS Our study demonstrated that being unmarried is an extremely important but neglected social risk factor for cognitive function. Sex was a strong effect modifier: being unmarried was correlated with a higher risk of cognitive decline than being married in Chinese hypertensive men, especially among older men, but this correlation was not observed among women. Moreover, never married men showed poorer cognitive function than those who were divorced or widowed.
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Affiliation(s)
- Si Shen
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
| | - Jianduan Cheng
- Wuyuan Hospital of Traditional Chinese Medicine, Wuyuan, China
| | - Junpei Li
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
| | - Yanyou Xie
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
| | - Li Wang
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
| | - Xinlei Zhou
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China
| | - Wei Zhou
- grid.412455.30000 0004 1756 5980Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingjuan Zhu
- grid.412455.30000 0004 1756 5980Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- grid.412455.30000 0004 1756 5980Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianglong Tu
- Department of Neurology, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.
| | - Huihui Bao
- Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Xiaoshu Cheng
- grid.412455.30000 0004 1756 5980Department of Cardiovascular, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006 Jiangxi China ,grid.412455.30000 0004 1756 5980Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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Adler RH. Men and suicide: Primary care prevention in the era of COVID-19 and beyond. J Am Assoc Nurse Pract 2022; 34:572-578. [PMID: 34115718 DOI: 10.1097/jxx.0000000000000614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/13/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT The COVID-19 pandemic has had detrimental effects on mental health, including a predicted increase in suicidality, making suicide prevention a high priority. The rate of men's suicide in the United States is significantly higher than that of women's suicide. This case study considers the role of primary care advanced practice nurses in addressing the risks of suicide in their practice with male patients. It is argued that a gender-sensitive approach is necessary to be effective in male suicide prevention efforts.
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Affiliation(s)
- Rachel H Adler
- UT Health San Antonio, School of Nursing, San Antonio, Texas
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29
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Cavazzotto TG, de Lima Stavinski NG, Queiroga MR, da Silva MP, Cyrino ES, Serassuelo Junior H, Vieira ER. Age and Sex-Related Associations between Marital Status, Physical Activity and TV Time. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:502. [PMID: 35010761 PMCID: PMC8744982 DOI: 10.3390/ijerph19010502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 02/04/2023]
Abstract
Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.
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Affiliation(s)
| | - Natã Gomes de Lima Stavinski
- Graduate Program in Health Sciences, Center of Health Sciences, State University of Londrina, Londrina 86039-440, PR, Brazil
| | - Marcos Roberto Queiroga
- Department of Physical Education, Midwestern Parana State University, Guarapuava 85040-167, PR, Brazil
| | - Michael Pereira da Silva
- Graduate Program in Public Health, Faculty of Medicine, Federal University of Rio Grande, Rio Grande 96203-900, RIG, Brazil
| | - Edilson Serpeloni Cyrino
- Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Helio Serassuelo Junior
- Department of Sports Science at the State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL 33179, USA
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30
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Suicide Attempts Among Racial and Ethnic Groups in a Nationally Representative Sample. J Racial Ethn Health Disparities 2022; 9:1783-1793. [PMID: 34291440 PMCID: PMC8294284 DOI: 10.1007/s40615-021-01115-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/25/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate suicide attempt prevalence and potentially related sociodemographic and psychiatric factors among racial and ethnic groups. METHODS Between 2012 and 2013, the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted semi-structured interviews with 36,309 adults in the USA. We identified lifetime suicide attempt prevalence and significant predictors for each racial/ethnic group using stratified logistic regressions. Analyses were exploratory without a priori hypotheses. RESULTS Asian/Native Hawaiian/other Pacific Islander and Black individuals had the lowest prevalence of suicide attempts while Alaska Native/American Indian and White individuals had the highest prevalence. Identifying as female and meeting criteria for psychiatric diagnoses featuring mood regulation difficulties (depression, borderline personality disorder, bipolar I disorder) were consistently related to a suicide attempt history across racial and ethnic groups, whereas substance abuse disorders and other sociodemographic factors differed between racial and ethnic groups in their associations with suicide attempt history. CONCLUSIONS Although several factors were consistently related to suicide risk across racial and ethnic groups, the prevalence of suicide attempts and overall pattern of related factors were not uniform between racial and ethnic groups. POLICY IMPLICATIONS Study findings highlight the importance of considering suicide risk within the context of race and ethnicity both regarding the overall prevalence of risk and in determining personal factors associated with elevated risk. A failure to appreciate experiences related to race and ethnicity may adversely impact suicide risk assessment and treatment, ultimately contributing to health disparities. Results suggest that additional research is warranted.
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Chen X, Mo Q, Yu B, Bai X, Jia C, Zhou L, Ma Z. Hierarchical and nested associations of suicide with marriage, social support, quality of life, and depression among the elderly in rural China: Machine learning of psychological autopsy data. Front Psychiatry 2022; 13:1000026. [PMID: 36226103 PMCID: PMC9548573 DOI: 10.3389/fpsyt.2022.1000026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify mechanisms underpinning the complex relationships between influential factors and suicide risk with psychological autopsy data and machine learning method. DESIGN A case-control study with suicide deaths selected using two-stage stratified cluster sampling method; and 1:1 age-and-gender matched live controls in the same geographic area. SETTING Disproportionately high risk of suicide among rural elderly in China. PARTICIPANTS A total of 242 subjects died from suicide and 242 matched live controls, 60 years of age and older. MEASUREMENTS Suicide death was determined based on the ICD-10 codes. Influential factors were measured using validated instruments and commonly accepted variables. RESULTS Of the total sample, 270 (55.8%) were male with mean age = 74.2 (SD = 8.2) years old. Four CART models were used to select influential factors using the criteria: areas under the curve (AUC) ≥ 0.8, sensitivity ≥ 0.8, and specificity ≥ 0.8. Each model included a lead predictor plus 8-10 hierarchically nested factors. Depression was the first to be selected in Model 1 as the lead predictor; After depression was excluded, quality of life (QOL) was selected in Model 2; After depression and QOL were excluded, social support was selected in Model 3. Finally, after all 3 lead factors were excluded, marital status was selected in Model 4. In addition, CART demonstrated the significance of several influential factors that would not be associated with suicide if the data were analyzed using the conventional logistic regression. CONCLUSION Associations between the key factors and suicide death for Chinese rural elderly are not linear and parallel but hierarchically nested that could not be effectively detected using conventional statistical methods. Findings of this study provide new and compelling evidence supporting tailored suicide prevention interventions at the familial, clinical and community levels.
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Affiliation(s)
- Xinguang Chen
- Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | - Qiqing Mo
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China.,Guilin People's Hospital, Guilin, China.,Department of Epidemiology, Universtiy of Florida, Gaineville, FL, United States
| | - Bin Yu
- Department of Biostatistics and Epidemiology, School of Public Health, Wuhan University, Wuhan, China
| | - Xinyu Bai
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China.,People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Ma
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China
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Chen ZC, Wu H, Wang XD, Zeng Y, Huang G, Lv Y, Niu J, Meng X, Cai P, Shen L, Gang B, You Y, Lv Y, Ren Z, Shi Z, Ji Y. Association between marital status and cognitive impairment based on a cross-sectional study in China. Int J Geriatr Psychiatry 2022; 37. [PMID: 34729814 DOI: 10.1002/gps.5649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/31/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Marital status may have an impact on the elderly population's health, but few studies in China discussed about the association between marital status and cognitive impairment. OBJECTIVE To investigate the relationship between marital status and cognitive impairment. To compare the influences of marital status on dementia between men and women. METHODS This study was based on a representative national cross-sectional epidemiological survey in China. We randomly selected 13 provinces and municipalities and included 19,276 participants aged 65 years or older in our study. Data was collected by interviewing the participants about their sociodemographic characteristics, and neuropsychological testing was administered to the participants by neurologists. To analyze the association between marital status and cognitive impairment, multiple logistic regression was based on a series of models. RESULTS Among the 19,276 subjects, about 77.2% were married, 1.6% were single, 21.2% were divorced/separated or widowed. The odds ratios (OR) of dementia were higher in single (OR: 2.13, CI: 1.53-2.97; p < 0.001), divorced/separated/widowed when they were ≤55 years old (OR: 1.75, CI: 1.30-2.35; p < 0.001), and divorced/separated/widowed when they were >55 years old (OR: 1.16, CI: 1.03-1.31; p < 0.001) participants than in married ones. Divorced/separated/widowed ≤55 men had about 2.75 times increase in dementia risk than married men. CONCLUSION People with long-term divorced/separated/widowed status would be associated to cognitive impairment more than those with short-term divorced/separated/widowed status. Men may be affected by marriage disruption more than women in terms of increasing the risk of dementia.
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Affiliation(s)
- Zhi-Chao Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Wu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Guowei Huang
- Department of Nutrition and Food Science, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yang Lv
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianping Niu
- Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Xinling Meng
- Department of Neurology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, China
| | - Pan Cai
- Dementia Clinic, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Baozhi Gang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yong You
- Department of Neurology, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yan Lv
- Department of Neurology, Hainan General Hospital, Haikou, China
| | - Zhihong Ren
- Department of Neurology, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, China
| | - Zhihong Shi
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
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Li S, Chai R, Wang Y, Wang J, Dong X, Xu H, Wu H, Binnay IT, Liu Z. A survey of mental health status of obstetric nurses during the novel coronavirus pneumonia pandemic. Medicine (Baltimore) 2021; 100:e28070. [PMID: 34967352 PMCID: PMC8718244 DOI: 10.1097/md.0000000000028070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the mental health status of obstetric nurses and its influencing factors during the novel coronavirus epidemic period, so as to provide theoretical reference for hospital decision-makers and managers.From February 25 to March 20, 2020, we conducted a cross-sectional survey through online questionnaire, and selected obstetric nurses from Jilin and Heilongjiang Provinces as the research objects by convenience sampling.Three hundred eighteen valid questionnaires were collected; the results of Symptom Checklist 90 showed that the scores of "obsessive-compulsive", "depression", "anxiety", "hostility", "phobia", and "psychosis" were higher than the Chinese norm (P < .01). There were 107 people whose total score of Symptom Checklist 90 was more than 160, and 83 people whose number of positive items was more than 43. Logistic regression results showed that married, temporary employment, lack of support and communication from family and relatives, onerous task, and unbearable responsibility were independent risk factors for mental disorder.There is a great psychological burden for obstetric nurses during the epidemic period. Decision makers should focus on necessary psychological intervention for those that are married, temporarily employed, and those lacking family supports including communication. At the same time, managers should distribute tasks reasonably to avoid psychological burdens caused by overwork.
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Affiliation(s)
- Shuyue Li
- Changchun Maternity Hospital, Changchun, Jilin, China
| | - Ruiyu Chai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yingshuang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Han Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Huiyan Wu
- The First Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Isaac T.S. Binnay
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhigang Liu
- Department of Pain Management, The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, Jilin, China
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Bornovski Y, Jackson-Shaheed E, Argraves S, Hitchins A, Tolchin B, Galluzzo D, Cheung KH, Goulet J, Skanderson M, Brandt CA, Pugh MJ, Altalib H. Suicide and Seizures: A National Cohort Study in Veterans. Neurol Clin Pract 2021; 11:372-376. [PMID: 34840864 DOI: 10.1212/cpj.0000000000001070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/18/2021] [Indexed: 11/15/2022]
Abstract
Objective The increased rate of suicide associated with epilepsy has been described, but no studies have reported the rates of suicide and suicide-related behavior (SRB) associated with psychogenic nonepileptic seizures (PNESs). Methods This retrospective cohort study analyzed data from October 2002 to October 2017 within Veterans Health Administration services. Of 801,734 veterans, 0.09% had PNES, 1.37% had epilepsy, and 98.5% had no documented seizures. Veterans coded for completed suicide, suicide attempts, and suicidal ideation were identified from electronic health records. The primary measure was the suicide-specific standardized mortality ratio (SMR) based on the number of suicide deaths and CDC national suicide mortality database. A Poisson regression was used to calculate the relative risk (RR) of suicide across groups. Results A total of 1,870 veterans (mean age [SD] 33.76 [7.81] years) completed suicide. Veterans with PNES (RR = 1.75, 95% confidence interval [CI] 0.84-4.24) and veterans with epilepsy (RR = 2.19, 95% CI 2.10-2.28) had a higher risk of suicide compared with the general veteran population. Veterans with PNES or epilepsy had a higher risk of suicide and SRB if they had comorbid alcohol abuse, illicit drug abuse, major depression, posttraumatic stress disorder, and use of psychotropic medications. Conversely, those who were married or attained higher education were at a decreased risk. The SMR for completed suicide for PNES, epilepsy, and the comparison group was 2.65 (95% CI 1.95-5.52), 2.04 (95% CI 1.60-2.55), and 0.70 (95% CI 0.67-0.74), respectively. Conclusions Veterans with seizures (both psychogenic and epileptic) are at a greater risk of death by suicide and SRB than the comparison group. These findings suggest that although the pathophysiology of PNES and epilepsy is different, the negative impact of seizures is evident in the psychosocial outcomes in both groups.
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Affiliation(s)
- Yarden Bornovski
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Ebony Jackson-Shaheed
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Stephanie Argraves
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Adrianna Hitchins
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Benjamin Tolchin
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Daniela Galluzzo
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Kei-Hoi Cheung
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Joseph Goulet
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Melissa Skanderson
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Cynthia A Brandt
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Mary Jo Pugh
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
| | - Hamada Altalib
- Department of Neurology (YB, EJ-S, SA, BT, HA), Yale School of Medicine, New Haven, CT; University of Rochester Medical Center (AH); Westchester Medical Center (DG), NY; Connecticut VA Healthcare System (K-HC, JG, MS, CAB), West Haven; Department of Emergency Medicine (K-HC, JG, CAB), Yale School of Medicine, New Haven; and VA Salt Lake City Healthcare System (MJP), University of Utah
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Reis A, Sperandei S, de Carvalho PGC, Pinheiro TF, de Moura FD, Gomez JL, Porchat P, Bastos FI, McFarland W, Wilson EC, Veras MA. A cross-sectional study of mental health and suicidality among trans women in São Paulo, Brazil. BMC Psychiatry 2021; 21:557. [PMID: 34758758 PMCID: PMC8579408 DOI: 10.1186/s12888-021-03557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/20/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Trans women have been shown to experience disproportionately poor outcomes in physical and mental health. Although it is common to talk about the violence against trans people, little is still known about mental health outcomes and experiences of suicidality among trans women, particularly in developing countries. This study aims to investigate risk factors and associations with mental health, suicide ideation and suicide attempts among trans women in the largest metropolitan area in Brazil. METHODS Trans women living in São Paulo were recruited between May 2017 and July 2019 using the long-chain peer referral method Respondent-Driven Sampling. Multivariate regression models were used to investigate the associations with K10 score classification (logistic) and suicidal ideation/suicide attempt (ordinal logistic). RESULTS A total of 763 trans women were included in the study. Over one quarter (26.5%) of trans women had been diagnosed with anxiety in the past, and close to one in five (19.1%) trans women had received a diagnosis of depression. More than two in five (41.9%) trans women had moderate to severe psychological distress. More than half of all participating trans women reported having previously either experienced suicidal ideation or attempted to take their own lives (25.0 and 31.2% respectively). In multivariate regression, moderate to severe psychological distress was associated with homelessness, income, current sex work, use of stimulant drugs, history of physical abuse, depression diagnosis and access to mental health treatment. Suicidal ideation and suicide attempts were associated with race/skin color, living arrangements, marital status, current sex work, history of sexual violence, depression and PTSD diagnoses, access to mental health treatment and psychological distress. CONCLUSIONS This study showed that there is a significant association between mental health conditions, lack of treatment for these conditions and suicidality among trans gender women. Findings point to the need for a structural transformation in Brazil that enables a reduction in the social inequality and violence that impact the mental health of trans women. A number of recommendations to achieve this are provided.
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Affiliation(s)
- Arianne Reis
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Penrith, Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Sandro Sperandei
- grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | | | - Thiago Félix Pinheiro
- grid.419014.90000 0004 0576 9812Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil
| | - Ferdinando Diniz de Moura
- grid.419014.90000 0004 0576 9812Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil
| | - José Luis Gomez
- grid.419014.90000 0004 0576 9812Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil
| | - Patrícia Porchat
- grid.410543.70000 0001 2188 478XSchool of Sciences, São Paulo State University, Bauru, Brazil
| | - Francisco Inácio Bastos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Willi McFarland
- grid.410359.a0000 0004 0461 9142San Francisco Department of Public Health, Center for Public Health Research, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Statistics, University of California, San Francisco, CA USA
| | - Erin C. Wilson
- grid.410359.a0000 0004 0461 9142San Francisco Department of Public Health, Trans Research unit for Equity (TRUE), San Francisco, CA USA
| | - Maria Amélia Veras
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil.
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Stack S. Contributing factors to suicide: Political, social, cultural and economic. Prev Med 2021; 152:106498. [PMID: 34538366 DOI: 10.1016/j.ypmed.2021.106498] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/10/2021] [Accepted: 02/27/2021] [Indexed: 11/16/2022]
Abstract
This review summarizes recent research in four environmental areas affecting risk of deaths by suicide. Politically, the weight of the evidence suggests that laws increasing social welfare expenditures and other policies assisting persons with low incomes (e.g., minimum wage) tend to lower suicide rates. Other legal changes such as those restricting firearms and alcohol availability can also prevent suicides. The social institutions of marriage, as well as parenting, continue to serve as protective factors against suicide, although the degree of protection is often gendered. Religiousness tends to be inversely associated with suicide deaths at the individual level of analysis, but the mediators need exploration to determine what accounts for the association: social support, better mental health, better physical health, less divorce, or other covariates. Cultural definitions of the traditional male role (e.g., breadwinner culture) continue to help explain the high male to female suicide ratio. New work on the "culture of suicide" shows promise. The degree of approval of suicide is sometimes the single most important factor in predicting suicide. At the individual level of analysis, two of the strongest predictors of suicide are economic ones: unemployment and low socio-economic status. Attention is drawn to enhancing the minimum wage as a policy known to lower state suicide rates. Limitations of research include model mis-specification, conflicting results especially when ecological data are employed, and a need for more research exploring moderators of established patterns such as that between religiousness and suicide.
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Kumar K, Srivastava S, Sharma B, Avasthi RK, Kotru M. Comparison Between Inflammatory Biomarkers (High-Sensitivity C-Reactive Protein and Neutrophil-Lymphocyte Ratio) and Psychological Morbidity in Suicide Attempt Survivors Brought to Medicine Emergency. Cureus 2021; 13:e17459. [PMID: 34603861 PMCID: PMC8475737 DOI: 10.7759/cureus.17459] [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] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: This study aimed to compare inflammatory biomarkers (high-sensitivity {hs} C-reactive protein, neutrophil-lymphocyte ratio) and psychological morbidity in suicide attempt survivors. Methods: One hundred ninety-eight poisoning cases screened, 40 age-matched suicide attempt survivors (SAS), 40 healthy controls (HC) between the age of 18 years and 60 years were included. Complete hemogram, neutrophil-lymphocyte ratio (NLR), hsCRP values obtained, compared with Hospital Anxiety and Depression Scale (HADS), suicide intent scale, presumptive stressful life events scale (PSLES), general health questionnaire 12-item (GHQ-12) (Hindi version), and Hindi Mental State Examination (HMSE). Results: A statistically significant difference was observed in hsCRP (p=0.016) and NLR (p=0.029) of depressed-suicidal participants vs healthy controls. hsCRP values of anxious-suicidal subjects vs healthy controls showed a statistically significant difference (p=0.001). There was a statistically significant difference between patients, healthy controls in HADS anxiety and HADS depression mean scores (p<0.001). The PSLES items were ranked according to the mean stress scores of all the items (mean±SD), highest four were excessive alcohol use by the family member 47.50 (±27.03), conflicts with in-laws 50 (±27.73), family conflict 50 (±29.42), marital conflict 50.63 (±32.76). There was a statistically significant difference in hemoglobin (p<0.001), red blood cells count (p<0.001), hematocrit (p<0.001) between suicide attempt survivors and healthy controls. Conclusion: Both hsCRP and NLR have emerged as potential inflammatory biomarkers for depressive patients with suicidal attempts. Additionally, there may be a link between anemia and suicide risk in patients with depression.
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Affiliation(s)
- Kuldeep Kumar
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Shruti Srivastava
- Psychiatry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Bhanu Sharma
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Rajnish K Avasthi
- Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Mrinalini Kotru
- Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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Śmigielski W, Małek K, Jurczyk T, Korczak K, Gajda R, Cicha-Mikołajczyk A, Piwoński J, Śmigielska-Kolańska J, Śmigielski J, Drygas W, Gałecki P. Suicide Risk Factors among Polish Adults Aged 65 or Older in 2000-2018 Compared with Selected Countries Worldwide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9921. [PMID: 34574845 PMCID: PMC8465742 DOI: 10.3390/ijerph18189921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to determine the tendencies of change in suicide frequency among Polish adults aged 65 or older, recognize the importance of available socio-demographic data (age, sex, marital status, and education attainment level) and provide an in-depth psychological understanding of the obtained results. We analysed the influence of education and marital status on suicide risk in the Polish adult population aged 65 or older, which has not been previously presented in publications related to the Central Statistical Office or any other research. Our results indicated that male adults aged 65 or older that were single or divorced and with a lower education had a higher risk of death by suicide. In female adults aged 65 or older, those with higher education and who were divorced or married had a higher risk of fatal suicide behaviour meanwhile, single women and widows had a lower risk. The dominant method of suicide among Polish older adults was suicide by hanging, regardless of sex; female older adults were more likely to die by suicide by poisoning or jumping from a height, and male older adults were more likely to die by shooting with a firearm. Although data from recent years highlights a downward trend for suicide rates in Polish older adults, the problem cannot be considered solved.
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Affiliation(s)
- Witold Śmigielski
- Department of Demography, University of Lodz, 41, Rewolucji 1905 St., 90-214 Lodz, Poland
- Department of Epidemiology Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland; (A.C.-M.); (J.P.); (W.D.)
| | - Karolina Małek
- Faculty of Psychology, Warsaw University, 26/28 Krakowskie Przedmieście St., 00-927 Warsaw, Poland;
- The Specialist Family Clinic of Bemowo District in the Capital City of Warsaw, Gen. T. Pełczyńskiego 28 E. St., 01-471 Warsaw, Poland;
| | - Tomasz Jurczyk
- The Specialist Family Clinic of Bemowo District in the Capital City of Warsaw, Gen. T. Pełczyńskiego 28 E. St., 01-471 Warsaw, Poland;
| | - Karol Korczak
- Department of Computer Science in Economics, University of Lodz, 41 Rewolucji 1905 St., 90-214 Lodz, Poland;
| | - Robert Gajda
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pułtusk, Piotra Skargi 23/29 St., 06-100 Pułtusk, Poland;
| | - Alicja Cicha-Mikołajczyk
- Department of Epidemiology Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland; (A.C.-M.); (J.P.); (W.D.)
| | - Jerzy Piwoński
- Department of Epidemiology Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland; (A.C.-M.); (J.P.); (W.D.)
| | - Joanna Śmigielska-Kolańska
- Specialist Psychiatric Health Center in Lodz, Babiński Hospital, 159 Aleksandrowska St., 91-229 Lodz, Poland;
| | - Janusz Śmigielski
- Department of Health Sciences, State University of Applied Sciences in Konin, 1 Przyjaźni St., 62-510 Konin, Poland;
| | - Wojciech Drygas
- Department of Epidemiology Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland; (A.C.-M.); (J.P.); (W.D.)
- Department of Preventive and Social Medicine, Medical University of Lodz, 4 Tadeusza Kościuszki St., 90-419 Lodz, Poland
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, 4 Tadeusza Kościuszki St., 90-419 Lodz, Poland;
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Wang L, Liu J, Yang Y, Zou H. Prevalence and risk factors for non-suicidal self-injury among patients with depression or bipolar disorder in China. BMC Psychiatry 2021; 21:389. [PMID: 34348675 PMCID: PMC8335871 DOI: 10.1186/s12888-021-03392-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 07/25/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUNDS Non-suicidal self-injury is a serious health problem among patients with depression or bipolar disorder. However, few studies within the Chinese context have investigated the prevalence of NSSI and its risk factors in above populations. The purpose of this study was to investigate the prevalence of non-suicidal self-injury and its risk factors in patients with depression or bipolar disorder in China. METHODS The final sample comprised of 394 inpatients(Mage = 29.71; SDage = 11.95) with depression or bipolar disorder from two psychiatric hospitals in Beijing, China. A General Demographic Data Form, the Non-suicidal Self-injury Questionnaire(NSSI-Q), Impulsivity Item and the Adverse Childhood Experiences-International Questionnaire(ACE-IQ) were completed by all patients. RESULTS Of the 394 patients examined, 245(62.2%) of this sample reported NSSI in past year. Of the 245 patients with NSSI, 135(55.1%) were diagnosed with depression and 110(44.9%) were diagnosed with bipolar disorder. The most common methods of NSSI for female was "pinching"(23.1%) and "scratching"(22.8%), while for male it was "hiting hard objects"(12.7%). By multivariate regression analysis, young age, unemployment, a higher monthly family income, single, impulsivity, long duration of illness and ACEs were risk factors for NSSI in patients with depression and bipolar disorder(P<0.05). CONCLUSIONS Our study points to the fact that there was an unfortunate message about the prevalence of NSSI among patients with depression or bipolar disorder in China. It is necessary not only to raise the awareness of NSSI in families and society, but also to formulate targeted assessment and intervention. Moreover, future research should not only focus on individuals being hospitalized, but should be representative of individuals treated at home or in the community because there are no national statistics on NSSI among such patients in China.
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Affiliation(s)
- Lu Wang
- grid.186775.a0000 0000 9490 772XSchool of Nursing, Anhui Medical University, No.69 Mei Shan Road, Shu Shan District, Hefei, 230031 Anhui Province China
| | - Jun Liu
- Department of Nursing, Beijing An Ding Hospital, 5 Ankang Lane, Xicheng District, Beijing, 100088 China
| | - Yuan Yang
- Department of Nursing, Beijing An Ding Hospital, 5 Ankang Lane, Xicheng District, Beijing, 100088 China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, Badachu Road, Shijingshan District, Beijing, 100144, China.
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Lall MD, Bilimoria KY, Lu DW, Zhan T, Barton MA, Hu YY, Beeson MS, Adams JG, Nelson LS, Baren JM. Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US. JAMA Netw Open 2021; 4:e2121706. [PMID: 34410392 PMCID: PMC8377562 DOI: 10.1001/jamanetworkopen.2021.21706] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. OBJECTIVE To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. DESIGN, SETTING, AND PARTICIPANTS In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. MAIN OUTCOMES AND MEASURES The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. RESULTS Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). CONCLUSIONS AND RELEVANCE In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.
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Affiliation(s)
- Michelle D. Lall
- Department of Emergency Medicine, Emory University, Atlanta, Georgia
| | | | - Dave W. Lu
- Department of Emergency Medicine, University of Washington, Seattle
| | - Tiannan Zhan
- Department of Surgery, Northwestern University, Chicago, Illinois
| | | | - Yue-Yung Hu
- Department of Surgery, Northwestern University, Chicago, Illinois
| | | | - James G. Adams
- Department of Emergency Medicine, Northwestern University, Chicago, Illinois
| | - Lewis S. Nelson
- Department of Emergency Medicine, Rutgers University, New Brunswick, New Jersey
| | - Jill M. Baren
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia
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Caravaca Sánchez F, Aizpurua E, Ricarte JJ, Barry TJ. Personal, Criminal and Social Predictors of Suicide Attempts in Prison. Arch Suicide Res 2021; 25:582-595. [PMID: 32169026 DOI: 10.1080/13811118.2020.1738293] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous epidemiological analyses indicate that specific demographic and criminal factors might be associated with suicide attempts during incarceration. However, there is a relative lack of research examining the role of social variables such as perceived social support. Data from 943 male inmates enrolled from three correctional facilities in Spain were collected. Participants completed self-report measures of the demographic, penitentiary and sentence-related, social support and suicide attempts variables. Approximately 1 in 11 inmates indicated that they had attempted suicide during incarceration. Inmates who were 50 years or above and who were serving longer sentences were significantly more likely to attempt suicide. Perceived social support was not associated with suicide attempts. These characteristics might be included in the development of intervention programs for incarcerated individuals.
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Næss EO, Mehlum L, Qin P. Marital status and suicide risk: Temporal effect of marital breakdown and contextual difference by socioeconomic status. SSM Popul Health 2021; 15:100853. [PMID: 34222610 PMCID: PMC8242039 DOI: 10.1016/j.ssmph.2021.100853] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/03/2021] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
Research has shown that people who have never been married, divorced, or widowed are at an increased risk of suicide compared with those who are married, but we have little knowledge as to how this elevated risk is modified by socioeconomic factors, and little research has studied the risk among persons enduring a marital separation. This study addressed these issues with individual-level data from Norwegian national registers. All suicide cases in people above 18 years that took place in the period 1992–2012 (n = 11 051) were compared with living controls (185 685) matched on sex and age via a nested case control design, and suicide risk associated with marital status was assessed with conditional logistic regression. The results showed that, compared with a status of being married, suicide risk was highly associated with a status of being never married, separated, divorced, or widowed, even after adjustment for income-level, educational attainment, centrality of residence, and immigration status. The strongest effect was seen for a separated status; compared to the married, separated persons were fully 6.06 times more apt to die by suicide, and the effect was strongest in the 30 days following a separation. The observed significant associations remained but differed in strength by sex and age, and there were significant deviations by personal socioeconomic status. Most notably, the increased risk was higher for never-married persons with low educational attainment or income. However, most interaction effects (10/16) did not yield significant results. In conclusion, suicide risk is strongly associated with a single status of any form with the highest risk during a marital separation, but the increased risk varies in strength according to individual-level factors. The stress and loss of support induced by marital dissolution are important contributing risk factors for suicide, and persons with low income may be especially vulnerable. Single status of any form was associated with increased risk of suicide. The risk was highest during the first month of a marital separation. A separated status had the strongest effect in middle-aged adults of both sexes. The risk for individuals who had never married differed by income and education.
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Affiliation(s)
- Erik Oftedahl Næss
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
| | - Lars Mehlum
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
| | - Ping Qin
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway
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Beghi M, Butera E, Cerri CG, Cornaggia CM, Febbo F, Mollica A, Berardino G, Piscitelli D, Resta E, Logroscino G, Daniele A, Altamura M, Bellomo A, Panza F, Lozupone M. Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neurosci Biobehav Rev 2021; 127:193-211. [PMID: 33878336 DOI: 10.1016/j.neubiorev.2021.04.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
In older age, several observational studies investigated risk factors for suicide attempts/completed suicides; however, contrasting evidence came from population-based setting. In the present systematic review, we described through a narrative synthesis the significant associations existing among risk factors and suicide attempts/completed suicides in subjects aged >65 years. From the 39 population-based studies selected in six different databases until February 15, 2021, we analyzed the most frequent 28 risk factors for suicidal behaviour. The risk factors more associated to suicide attempts than other variables frequently related to suicidal behavior in older age were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. In older age, efforts for suicide prevention should be based on strategies to assess and treat psychiatric disorders along with psychological interventions, particularly in males.
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Affiliation(s)
| | - Elisa Butera
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | | | | | - Francesca Febbo
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy; School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Emanuela Resta
- Translational Medicine and Management of Health Systems, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Panza
- Healthy Aging Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy.
| | - Madia Lozupone
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
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44
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Kim KA, Kim YE, Yoon SJ. Descriptive epidemiology on the trends and sociodemographic risk factors of disease burden in years of life lost due to suicide in South Korea from 2000 to 2018. BMJ Open 2021; 11:e043662. [PMID: 33637545 PMCID: PMC7919599 DOI: 10.1136/bmjopen-2020-043662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES In 2018, South Korea's suicide mortality rate was 26.59 deaths per 100 000 people; this figure is 2.2 times higher than that of the year 2000, during which 12.22 deaths per 100 000 people were ascribed to suicide. This study aims to observe the trend of disease burden in years of life lost (YLL) due to suicide from 2000 to 2018 in South Korea and investigate the related sociodemographic risk factors. DESIGN This quantitative research used secondary data-including claim data, cause of death statistics, life tables and census data-from national health insurance corporation and Statistics Korea. Based on the methodology of Korean National Burden of Disease study, this study used an incidence-based approach to measure YLL. RESULTS The total YLL due to suicide during the last two decades was 4 298 886 years; the average YLL per death was 18.65 years. The YLL rate per 100 000 people was 482 (male: 664, female: 300) in 2018, 1.7 times higher than the 387 (male 387, female 183) in 2000. Low education levels and non-marital status were shown to be related to the increase in YLL rate. CONCLUSION These results show the increasing disease burden of suicide in South Korea and suggest the necessity of more in-depth research to analyse correlation and causation with sociodemographic risk factors.
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Affiliation(s)
- Keun A Kim
- School of Military Medicine, The Armed Force Medical Command, Daejeon, South Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine of Seoul, Seoul, South Korea
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45
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Living alone, loneliness and lack of emotional support as predictors of suicide and self-harm: A nine-year follow up of the UK Biobank cohort. J Affect Disord 2021; 279:316-323. [PMID: 33096330 PMCID: PMC7758739 DOI: 10.1016/j.jad.2020.10.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/27/2020] [Accepted: 10/11/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The association between loneliness and suicide is poorly understood. We investigated how living alone, loneliness and emotional support were related to suicide and self-harm in a longitudinal design. METHODS Between 2006 and 2010 UK Biobank recruited and assessed in detail over 0.5 million people in middle age. Data were linked to prospective hospital admission and mortality records. Adjusted Cox regression models were used to investigate relationships between living arrangements, loneliness and emotional support, and both suicide and self-harm as outcomes. RESULTS For men, both living alone (Hazard Ratio (HR) 2.16, 95%CI 1.51-3.09) and living with non-partners (HR 1.80, 95%CI 1.08-3.00) were associated with death by suicide, independently of loneliness, which had a modest relationship with suicide (HR 1.43, 95%CI 0.1.01-2.03). For women, there was no evidence that living arrangements, loneliness or emotional support were associated with death by suicide. Associations between living alone and self-harm were explained by health for women, and by health, loneliness and emotional support for men. In fully adjusted models, loneliness was associated with hospital admissions for self-harm in both women (HR 1.89, 95%CI 1.57-2.28) and men (HR 1.74, 95%CI 1.40-2.16). LIMITATIONS Loneliness and emotional support were operationalized using single item measures. CONCLUSIONS For men - but not for women - living alone or living with a non-partner increased the risk of suicide, a finding not explained by subjective loneliness. Overall, loneliness may be more important as a risk factor for self-harm than for suicide. Loneliness also appears to lessen the protective associations of cohabitation.
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46
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Kielan A, Jaworski M, Mosiołek A, Chodkiewicz J, Święcicki Ł, Walewska-Zielecka B. Factors Related to the Level of Depression and Suicidal Behavior Among Men With Diagnosed Depression, Physically Ill Men, and Healthy Men. Front Psychiatry 2021; 12:644097. [PMID: 34248697 PMCID: PMC8260949 DOI: 10.3389/fpsyt.2021.644097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians. The study was aimed at establishing models of factors related to the level of depression and suicidal behavior among men from three different groups-in men with depressive disorder, in comparison to men with physical disorder and healthy men. A total of 598 men were included in the study. The following questionnaires were used in research model: test with sociodemographic variables, AUDIT Test, Fagerström Test, Generalized Self-Efficacy Scale (GSES), Inventory for Measuring Coping with Stress (Mini-COPE), Resilience Evaluation Questionnaire (KOP-26), Suicide Behaviors Questionnaire-Revised (SBQ-R) by Osman, and Gotland Male Depression Scale. In men with depression, the positive factors strongly related to the intensity of depression and suicidal behavior were as follows: vocational education, active coping, turning toward religion, social competence for resilience, and bachelor status. The factors negatively related to the intensity of depression and suicidal behavior in this group were as follows: unemployed status, student status, low satisfaction with the financial situation, having children, history of mental disorders in family, alcohol addiction, and seeking instrumental support. In the group of men with physical disorders, the following protection factors were identified: the medium or small city as a place of living, active coping, venting, and personal competence. The following risk factors were identified in this group: psychiatric treatment in the past. In the group of healthy men, the following protective factors were identified: the medium city as a place of living, positive reappraisal, planning abilities, and personal and social competence for resilience. In this group, the following risk factors were identified: vocational and higher education, student status, satisfaction with the financial situation, having more than one children, the occurrence of mental disorders in the family, the occurrence of alcohol abuse in the family, and use of psychoactive substances as a strategy of dealing with stress. The risk factors identified in this study should be included in the clinical assessment of depression and suicidal behavior risk in male patients. There are some protective factors identified, including productive coping and personal and social competencies, which can be developed and should be especially considered and strengthened in mental health promotion programs aimed at men.
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Affiliation(s)
- Aleksandra Kielan
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.,Polish Suicidological Association, Warsaw, Poland
| | - Mariusz Jaworski
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Anna Mosiołek
- Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Pruszków, Poland
| | - Jan Chodkiewicz
- Department of Psychoprophylaxis and Addiction Psychology, Institute of Psychology, University of Lodz, Łódz, Poland
| | - Łukasz Święcicki
- 2nd Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Bożena Walewska-Zielecka
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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47
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Pons-Baños J, Ballester-Ferrando D, Riesco-Miranda L, Escoté-Llobet S, Jiménez-Nuño J, Fuentes-Pumarola C, Serra-Millàs M. Sociodemographic and Clinical Characteristics Associated with Suicidal Behaviour and Relationship with a Nurse-Led Suicide Prevention Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238765. [PMID: 33255772 PMCID: PMC7728328 DOI: 10.3390/ijerph17238765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. Aims: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. Methods: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013–2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. Results: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. Conclusion: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.
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Affiliation(s)
- Judit Pons-Baños
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - David Ballester-Ferrando
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain;
- Correspondence: ; Tel.: +34-972-418771
| | - Lola Riesco-Miranda
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
| | - Santiago Escoté-Llobet
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - Jordi Jiménez-Nuño
- Vic Forensic Medicine Department, Institute of Legal Medicine and Forensic Sciences of Catalonia, 08500 Vic, Spain;
| | | | - Montserrat Serra-Millàs
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
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48
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Abou El-Magd RM, Urichuk L, Surood S, Li D, Greenshaw A, Grunau M, MacNeil L, Challborn I, Grauwiler D, Olson R, Agyapong VIO. Family Members' Perspectives on Family and Social Support Available to Suicidal Patients, and Health Systems' Interactions and Responses to Suicide Cases in Alberta: Protocol for a Quantitative Research Study. JMIR Res Protoc 2020; 9:e19112. [PMID: 33231553 PMCID: PMC7723743 DOI: 10.2196/19112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/02/2020] [Accepted: 08/18/2020] [Indexed: 11/15/2022] Open
Abstract
Background Suicide is a major cause of preventable death globally and a leading cause of death by injury in Canada. To support people who experience suicidal thoughts and behaviors and to ultimately prevent people from dying by suicide, it is important to understand individual and familial experiences with the health care system. Objective We present the protocol for a study, the objective of which is to explore how people who died by suicide, and their family members, interacted with the health care system. Methods This is a quantitative research study. Data will be collected through a self-administered paper-based or online survey of the family member of patients who died by suicide. The sample size was calculated to be 385 (margin of error ±3%). Results Data collection will start in October 2020 and results will be available by March 2021. We expect the results to shed light on the experiences of individuals who died by suicide and their family members with the health care system. The study has received ethical clearance from the Health Ethics Research Board of the University of Alberta (Pro00096342). Conclusions Our study may inform practice, policy, and future research. The findings may shape how members of the health care system respond to people who are at risk of suicide and their families. International Registered Report Identifier (IRRID) PRR1-10.2196/19112
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Affiliation(s)
- Rabab M Abou El-Magd
- Department of Psychiatry, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Liana Urichuk
- Addiction & Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction & Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Daniel Li
- Addiction & Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mara Grunau
- Centre for Suicide Prevention, Calgary, AB, Canada
| | | | - Ione Challborn
- Canadian Mental Health Association, Edmonton, AB, Canada
| | | | - Robert Olson
- Centre for Suicide Prevention, Calgary, AB, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.,Addiction & Mental Health, Alberta Health Services, Edmonton, AB, Canada
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49
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Balint L, Fuzer K, Gonda X, Dome P. Estimation of the relationship between the persistent decrease of the suicide rate and the changes in sociodemographic composition in Hungary between 1990 and 2011. PLoS One 2020; 15:e0241314. [PMID: 33095839 PMCID: PMC7584192 DOI: 10.1371/journal.pone.0241314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
From the end of the 1980s, the Hungarian suicide rate, which had been until that point the highest in the world for decades, has decreased drastically. The reason behind this decrease was probably due to the changes in numerous and often interlinked risk factors. Studies on this topic have mostly ignored to interrogate to what extent the change of the population composition, for example the improvement of educational level, contributed to the decrease of the rate in the given period? Our aim was to assess the contribution of changes in some sociodemographic factors to the decrease of the suicide rate in Hungary. During the analysis, data from 1990 were compared with data from 2011. For the statistical calculations, the method of “Standardization and Decomposition (SDA)” was used, which according to our best knowledge, has not yet been applied in Hungarian suicide studies. The results show that the improvement of educational level helped to decrease the rate for men by about a third, while for women only by about a tenth. However, the benefit of the improvement in educational attainment during the period investigated was significantly offset by the changes primarily in marital status (the ratios of unmarried and divorced subjects increased for both genders) and in age distribution (the ratio of the elderly persons increased for both genders). The results of our study emphasise the inverse relationship between suicide and educational level and support the hypothesis that we can regard educational policy as indirect health policy.
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Affiliation(s)
- Lajos Balint
- Demographic Research Institute of the Hungarian Central Statistical Office, Budapest, Hungary
- Department of Sociology, University of Pécs, Pécs, Hungary
- * E-mail: (LB); , (PD)
| | - Katalin Fuzer
- Department of Sociology, University of Pécs, Pécs, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Faculty of Medicine, Budapest, Hungary
- Nyiro Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
- NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Faculty of Medicine, Budapest, Hungary
- Nyiro Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
- * E-mail: (LB); , (PD)
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50
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Baldaçara L, Rocha GA, Leite VDS, Porto DM, Grudtner RR, Diaz AP, Meleiro A, Correa H, Tung TC, Quevedo J, da Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 1. Risk factors, protective factors, and assessment. ACTA ACUST UNITED AC 2020; 43:525-537. [PMID: 33111773 PMCID: PMC8555650 DOI: 10.1590/1516-4446-2020-0994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/21/2020] [Indexed: 12/28/2022]
Abstract
Suicide is a global public health problem that causes the loss of more than 800,000 lives each year, principally among young people. In Brazil, the average mortality rate attributable to suicide is approximately 5.23 per 100,000 population. Although many guidelines have been published for the management of suicidal behavior, to date, there are no recent guidelines based on the principles of evidence-based medicine that apply to the reality of suicide in Brazil. The objective of this work is to provide key guidelines for managing patients with suicidal behavior in Brazil. This project involved 11 Brazilian psychiatry professionals selected by the Psychiatric Emergencies Committee (Comissão de Emergências Psiquiátricas) of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. For the development of these guidelines, 79 articles were reviewed (from 5,362 initially collected and 755 abstracts). In this review, we present definitions, risk and protective factors, assessments, and an introduction to the Safety Plan. Systematic review registry number: CRD42020206517
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Affiliation(s)
- Leonardo Baldaçara
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
| | - Gislene A Rocha
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil.,Serviço Especializado em Reabilitação em Deficiência Intelectual, Associação de Pais e Amigos dos Excepcionais, Montes Claros, MG, Brazil
| | - Verônica da S Leite
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Secretaria Municipal de Saúde de Palmas, Palmas, TO, Brazil
| | - Deisy M Porto
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Associação Catarinense de Psiquiatria, Florianópolis, SC, Brazil
| | - Roberta R Grudtner
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Núcleo de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Secretaria Estadual da Saúde, Porto Alegre, RS, Brazil
| | - Alexandre P Diaz
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | - Humberto Correa
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Teng C Tung
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.,Serviços de Pronto Socorro e Interconsultas, IPq, HCFMUSP, São Paulo, SP, Brazil
| | - João Quevedo
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Antônio G da Silva
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Asociación Psiquiátrica de América Latina (APAL)
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